FR2805146A1 - Pince pour degager du tissu dans des cavites corporelles - Google Patents
Pince pour degager du tissu dans des cavites corporelles Download PDFInfo
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- FR2805146A1 FR2805146A1 FR0102285A FR0102285A FR2805146A1 FR 2805146 A1 FR2805146 A1 FR 2805146A1 FR 0102285 A FR0102285 A FR 0102285A FR 0102285 A FR0102285 A FR 0102285A FR 2805146 A1 FR2805146 A1 FR 2805146A1
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- branches
- teeth
- forceps
- jaw
- clamp
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- Legal status (The legal status 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 status listed.)
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- 201000004458 Myoma Diseases 0.000 claims abstract description 11
- 210000004291 uterus Anatomy 0.000 claims abstract description 8
- 230000000630 rising effect Effects 0.000 claims description 5
- 206010061692 Benign muscle neoplasm Diseases 0.000 description 7
- 238000000926 separation method Methods 0.000 description 2
- 238000010276 construction Methods 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000000007 visual effect Effects 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
- A61B10/02—Instruments for taking cell samples or for biopsy
- A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Ophthalmology & Optometry (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
La présente invention concerne une pince pour dégager du tissu dans des cavités corporelles, notamment des myomes situés dans l'épaisseur de la paroi de l'utérus, laquelle pince comporte une mâchoire de pince (6) présentant deux branches (7) susceptibles de pivoter dans un plan d'intervention, autour d'un axe commun (4), pour ouvrir et fermer la mâchoire de pince (6), et qui, lorsque la mâchoire de pince (6) est vide et fermée, s'appliquent l'une contre l'autre par des surfaces de prise (8) structurées. Selon l'invention, les branches (7) sont chacune pourvues extérieurement, au niveau de leur dos (10) opposé à la surface de prise (8) et sur une partie de leur longueur, d'un profil de dos en dents (11).
Description
La présente invention se rapporte à une pince pour dégager du tissu dans
des cavités corporelles, notamment des myomes situés dans l'épaisseur de la paroi de l'utérus, laquelle pince comporte une mâchoire de pince présentant deux branches susceptibles de pivoter dans un plan d'intervention, autour d'un axe commun, pour ouvrir et fermer la mâchoire de pince, et qui, lorsque la mâchoire de pince est vide et fermée,
s'appliquent l'une contre l'autre par des surfaces de prise structurées.
De telles pinces comportent une mâchoire de pince présentant deux branches qui, à leur dos, ont une configuration en surface lisse et qui, la mâchoire de pince étant fermée, sont insérées dans la région entre le myome et la paroi de l'utérus et, dans l'état d'écartement mutuel, c'està-dire lorsque la mâchoire de pince est ouverte, sont tirées en arrière. On doit, de cette façon, parvenir à ce que les structures tissulaires reliant le myome à la paroi de l'utérus soient sectionnées. Il apparaît toutefois que, dès l'écartement des branches et en particulier au moment o la mâchoire de pince ouverte est tirée vers le côté proximal, le tissu saisi glisse, de façon incontrôlée, des dos des branches et, de ce fait, n'est pas détaché. Par ailleurs, dans les pinces connues, les branches sont d'une réalisation relativement courte, de sorte qu'une faible proportion de tissu seulement peut être prise, ce qui limite
l'efficacité de la pince.
La présente invention s'est dès lors fixé pour but de procurer une pince dont l'action de détachement soit nettement améliorée et qui puisse
être utilisée d'une façon globalement plus efficace.
Pour ce faire, la présente invention propose une pince du type mentionné en introduction, qui se caractérise en ce qu'à leur dos opposé à la surface de prise, les branches de la mâchoire de pince sont chacune pourvues extérieurement, sur une partie de leur longueur, d'un profil de dos
en dents.
Les avantages pouvant être obtenus de cette façon résident notamment dans le fait que, lorsque la mâchoire de pince est insérée entre le myome et la paroi de l'utérus et est ensuite ouverte, le tissu, dont se chargent alors les dos de ses branches, est empêché, grâce au profil de dos, de glisser des branches. Le tissu peut ainsi, de façon sûre, être mis sous une tension requise pour qu'il soit détaché et peut être parfaitement bien sectionné lorsque la mâchoire de pince ouverte est tirée en arrière. La sûreté du
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sectionnement du tissu peut alors être encore renforcée grâce au fait que, dans chacun des profils de dos, est disposée, le long de l'axe longitudinal médian, une lame présentant un tranchant dirigé vers l'extérieur, qui, de préférence, se termine au ras du profil de dos, c'est-à-dire vient se placer dans un plan contenant les crêtes voisines du profil de dos. Selon une autre caractéristique préférée, le profil de dos peut être réalisé sous la forme d'une série de dents de scie, ces dents pouvant s'étendre transversalement sur les dos des branches et jusque dans la région des surfaces de prise de ces dernières. S'est alors avérée être particulièrement efficace, dans l'optique du but fixé, une forme de réalisation selon laquelle les dents possèdent chacune un flanc droit et un flanc montant, ces dents étant disposées de façon que, dans la direction proximale, au flanc droit d'une dent donnée est rattachée le flanc montant de
la dent suivante.
Un mode de réalisation de la présente invention va maintenant être décrit plus en détail, mais uniquement à titre d'exemple non limitatif, en référence au dessin annexé, sur lequel: la figure 1 est une vue d'ensemble de la partie distale d'une pince conforme à ce mode de réalisation de l'invention, représentée dans l'état ouvert, la figure 2 est une représentation à plus grande échelle d'une branche de la pince de la figure 1, la figure 3 est une vue en coupe transversale de cette même branche, effectuée suivant la ligne III-III sur la figure 2, et la figure 4 est une vue de dessus de la branche de pince de la
figure 2.
La pince conforme à la présente invention, visible sur la figure 1, se compose d'une tige tubulaire 1 qui, du côté proximal, est reliée, de manière connue, à une poignée non représentée de manipulation de la pince, munie d'une manette pivotante, et qui, du côté distal, comporte une tête fourchue 2 cylindrique, laquelle est pourvue d'un perçage transversal 3 dans la région de son extrémité distale. Ce perçage transversal sert de logement à un axe 4, autour duquel sont montées pivotantes deux branches 7 qui se dressent dans la région formée entre les ailes 5 de la tête fourchue 2, en définissant une
mâchoire de pince 6.
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Les deux branches 7 sont dotées de surfaces de prise 8, dans le plan desquelles s'étend l'axe 4 et qui sont structurées au moyen d'une multiplicité de dents 9, lesquelles s'appliquent les unes contre les autres lorsque la mâchoire de pince 6 est vide et fermée. Dans la position fermée, les branches 7 forment quasiment un corps cylindrique, qui est divisé dans le plan de l'axe 4 et qui se prolonge, côté proximal, dans la tête fourchue 2 cylindrique, par des bras de levier 15, et est arrondi, sous une forme sphérique, à son extrémité distale. Il s'ensuit que les extrémités distales des branches 7 présentent une configuration atraumatique et que les dos 10 des
branches, vus en coupe transversale, sont ronds.
Sur leur surface extérieure formant le dos 10, les branches 7 sont dotées, sur une partie de leur longueur, d'un profil de dos en dents 11, dont les dents 12 ont la configuration de dents de scie et possèdent un flanc droit 13 auquel se rattache un flanc 14 montant de la dent 12 respectivement placée à la suite, du côté proximal. Les dents 12 s'étendent dans le sens transversal sur la largeur des dos 10 des branches 7, en prenant naissance au voisinage des surfaces de prise structurées 8 et en se développant, sous une hauteur croissante, jusqu'à la crête des dos, o les crans, c'est-à-dire les
vides entre dents, présentent la plus grande profondeur.
L'ouverture et la fermeture de la mâchoire de la pince se font à l'aide de moyens connus et, de façon usuelle, par translation axiale d'une tringle d'actionnement 18. Du côté proximal, chaque branche 7 se termine par un bras de levier coudé 15 qui, dans la région de son extrémité proximale, possède un perçage transversal respectif 16, dans lequel est disposé un tourillon relié à une biellette 17. Chaque biellette est, du côté proximal, fixée à l'extrémité distale de la tringle d'actionnement 18, là encore par l'intermédiaire d'une liaison à tourillon et trou de réception. La tringle d'actionnement s'étend à travers la tige 1 et est reliée, côté proximal, à la manette pivotante de la poignée de manipulation de la pince, laquelle
comporte une autre manette fixée rigidement à la tige 1.
Lors de l'ouverture de la machoire de la pince insérée entre la paroi de l'utérus et le myome par application d'une pression appropriée, il se produit déjà un détachement de tissu. Lorsqu'ensuite la pince est tirée vers le côté proximal avec sa mâchoire ouverte, le tissu qui se trouve dans le trajet de déplacement des branches 7 est chargé sur les dos 10 des branches,
4 2805146
sous une tension allant en augmentant, et du tissu parviendra alors dans les vides formés entre les dents 12 et s'appliquera contre les flancs droits 13 des dents, lesquels maintiendront le tissu chargé dans la région des branches et le retiendront en l'empêchant de glisser de ces dernières, si bien qu'est garanti, de la sorte, un processus de détachement plus sûr, qui peut même être encore accéléré et amélioré grâce au fait que dans chacun des profils de dos 11 des branches 7, il est disposé, le long de l'axe longitudinal médian, une lame 19 présentant un tranchant 20 orienté vers l'extérieur, mais sans
toutefois dépasser du profil de dos, comme cela est souhaité.
Normalement, l'opération de détachement sera exécutée plusieurs fois, jusqu'à ce que le myome finisse par être complètement séparé de la paroi de l'utérus et puisse être extrait de ce dernier en étant saisi à l'aide de la mâchoire de la pince. Le détachement du myome s'effectue sous contrôle visuel au moyen d'un endoscope, la pince, qui en constitue alors un 1S instrument auxiliaire, étant poussée à travers un canal d'intervention, à l'intérieur de l'endoscope, jusqu'à ce que sa mâchoire atteigne le site opératoire. Après désintégration du myome, les fragments de ce dernier peuvent être extraits au travers du canal cervical. Lorsqu'ils sont de petite taille, les myomes peuvent aussi être saisis à l'aide de la pince et être retirés
de la cavité corporelle avec l'endoscope.
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Claims (6)
1. Pince pour dégager du tissu dans des cavités corporelles, notamment des myomes situés dans l'épaisseur de la paroi de l'utérus, laquelle pince comporte une machoire de pince (6) présentant deux branches (7) susceptibles de pivoter dans un plan d'intervention, autour d'un axe commun (4), pour ouvrir et fermer la mâchoire de pince (6), et qui, lorsque la mâchoire de pince (6) est vide et fermée, s'appliquent l'une contre l'autre par des surfaces de prise (8) structurées, caractérisée en ce qu'à leur dos (10) opposé à la surface de prise (8), les branches (7) sont chacune pourvues extérieurement, sur une partie de leur longueur, d'un profil de dos
en dents (11).
2. Pince selon la revendication 1, caractérisée en ce que, dans chacun des profils de dos (11), est disposée, le long de l'axe longitudinal
médian, une lame (19) présentant un tranchant (20) dirigé vers l'extérieur.
3. Pince selon la revendication 2, caractérisée en ce que le
tranchant (20) se termine au ras du profil de dos (11).
4. Pince selon l'une quelconque des revendications 1 à 3,
caractérisée en ce que le profil de dos (11) est réalisé sous la forme d'une série de dents de scie et en ce que les dents (12) s'étendent transversalement
sur les dos (10) des branches (7).
5. Pince selon la revendication 4, caractérisée en ce que les dents
(12) s'étendent jusque dans la région des surfaces de prise (8) des branches.
6. Pince selon la revendication 4 ou 5, caractérisée en ce que les dents (12) possèdent chacune un flanc droit (13) et un flanc montant (14), ces dents (12) étant disposées de façon que, dans la direction proximale, au flanc droit (13) d'une dent donnée est rattachée le flanc montant (14) de la
dent suivante.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE10007919A DE10007919C2 (de) | 2000-02-21 | 2000-02-21 | Zange zum Freipräparieren von Gewebe in einer Körperhöhle |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| FR2805146A1 true FR2805146A1 (fr) | 2001-08-24 |
| FR2805146B1 FR2805146B1 (fr) | 2003-11-07 |
Family
ID=7631754
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR0102285A Expired - Fee Related FR2805146B1 (fr) | 2000-02-21 | 2001-02-20 | Pince pour degager du tissu dans des cavites corporelles |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US6709445B2 (fr) |
| DE (1) | DE10007919C2 (fr) |
| FR (1) | FR2805146B1 (fr) |
| GB (1) | GB2360481B (fr) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2006124518A3 (fr) * | 2005-05-13 | 2007-03-22 | Boston Scient Scimed Inc | Ensembles forceps de biopsie |
| WO2013089545A1 (fr) * | 2011-12-16 | 2013-06-20 | Guzman Sanchez Arnoldo | Pince chirurgicale d'occlusion hermétique pour le col de l'utérus à utiliser dans des cas de placenta praevia |
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| DE60121229T2 (de) | 2001-04-06 | 2007-05-24 | Sherwood Services Ag | Vorrichtung zum abdichten und teilen eines gefässes mit nichtleitendem endanschlag |
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| CA2439536A1 (fr) * | 2003-09-04 | 2005-03-04 | Jacek Krzyzanowski | Variantes de mors et de chape pour dispositifs de biopsie et methode de fabrication |
| US7588545B2 (en) | 2003-09-10 | 2009-09-15 | Boston Scientific Scimed, Inc. | Forceps and collection assembly with accompanying mechanisms and related methods of use |
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| US5993461A (en) * | 1998-01-07 | 1999-11-30 | Abae; Mick | Laparoscopic instrument for manipulating the uterus during laparoscopic surgery |
| JP3331172B2 (ja) * | 1998-06-12 | 2002-10-07 | 旭光学工業株式会社 | 内視鏡用異物回収具 |
-
2000
- 2000-02-21 DE DE10007919A patent/DE10007919C2/de not_active Expired - Lifetime
-
2001
- 2001-01-18 GB GB0101336A patent/GB2360481B/en not_active Expired - Fee Related
- 2001-02-20 FR FR0102285A patent/FR2805146B1/fr not_active Expired - Fee Related
- 2001-02-21 US US09/789,351 patent/US6709445B2/en not_active Expired - Fee Related
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE1124184B (de) * | 1960-07-15 | 1962-02-22 | Zepf Geb | Chirurgisches Mehrzweck-Instrument, insbesondere fuer Hals-, Nasen- und Ohrenbehandlung |
| US5658307A (en) * | 1990-11-07 | 1997-08-19 | Exconde; Primo D. | Method of using a surgical dissector instrument |
| EP0835637A1 (fr) * | 1996-10-08 | 1998-04-15 | Asahi Kogaku Kogyo Kabushiki Kaisha | Accessoire de traitement pour endoscope |
| US5893878A (en) * | 1997-04-24 | 1999-04-13 | Pierce; Javin | Micro traumatic tissue manipulator apparatus |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2006124518A3 (fr) * | 2005-05-13 | 2007-03-22 | Boston Scient Scimed Inc | Ensembles forceps de biopsie |
| WO2013089545A1 (fr) * | 2011-12-16 | 2013-06-20 | Guzman Sanchez Arnoldo | Pince chirurgicale d'occlusion hermétique pour le col de l'utérus à utiliser dans des cas de placenta praevia |
| US9463025B2 (en) | 2011-12-16 | 2016-10-11 | Arnoldo Guzman Sanchez | Hermetic occlusion surgical clamp for the cervix in cases of placenta previa |
Also Published As
| Publication number | Publication date |
|---|---|
| DE10007919A1 (de) | 2001-08-30 |
| GB2360481B (en) | 2003-09-03 |
| GB0101336D0 (en) | 2001-03-07 |
| GB2360481A (en) | 2001-09-26 |
| FR2805146B1 (fr) | 2003-11-07 |
| US6709445B2 (en) | 2004-03-23 |
| US20010021861A1 (en) | 2001-09-13 |
| DE10007919C2 (de) | 2003-07-17 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| ST | Notification of lapse |
Effective date: 20111102 |