• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    An instrument for removing body tissue from a fistula tract (1) with a cutting tool (10) having a cutting edge (12) and a guide rod (30) for passing through the fistula tract (1). The cutting tool (10) is tubular and can be pushed onto the guide rod (30). The cutting tool (10) has a rear guide portion (16) for slidably guiding the cutting tool (10) on the guide rod (30) and a front cutting portion (11) on which at a front end of the cutting edge (12) is formed and its Inner diameter (15) for forming a receiving cavity (14) for receiving separated body tissue (5) is greater than the outer diameter (34) of the guide rod (30).
    公开号:AT516604A4
    申请号:T460/2015
    申请日:2015-07-13
    公开日:2016-07-15
    发明作者:
    申请人:Ami Agency Medical Innovations Gmbh；
    IPC主号:
    专利说明:

    The present invention relates to an instrument for removing body tissue from a fistula tract having a cutting tool having a cutting edge.
    Fistulas are not naturally pre-existing, tubular or tubular mesh-like connections between an internal hollow organ and other organs or the body surface of living things. The body may form one or more fistulous tracts to carry the pus resulting from inflammation out of an abscess.
    Fistulas, for example in the area of the anus, so-called anal fistulas, are very uncomfortable for those affected. The fistula tract connects the rectum with the body surface in the area of the anus of the patient. Anal fistulas often have an epithelial lining which forms a fistula wall of the fistula tract and has a thickness of about 0.5 mm or more. The epithelial lining makes it difficult to grow and heal the fistula by itself. The length of the fistula tract of anal fistulas is often in the range of 2 cm to 6 cm. The diameter of the fistula tract is usually more than 2 mm.
    There are various therapies for the treatment of fistulas, especially of anal fistulas known. If necessary, the pus is first drained from the fistula via a thread drainage. For this purpose, a thread is inserted into the fistula tract by means of a rod-shaped insertion aid and the two ends of the thread are knotted outside the patient's body. If possible, fistulas are then excised or split, sparing the sphincter, to allow healing of the fistula. This is particularly problematic in fistulas located near the sphincter, since radical removal can endanger the continence of the patient.
    By inserting a fistula closure from the inside into the fistula tract, e.g. From a resorbable implant, the extent of surgically removed body tissue can be reduced. Another fistula closure technique is the thermal treatment of the fistula tract, e.g. using a laser to destroy and occlude the fistula tract.
    Another form of therapy is to use a curette, i. a rod-shaped instrument with a widened front end, on which a cutting edge is formed to manually ablate the fistula wall, to allow a subsequent healing of the fistula. For this purpose, it is necessary to cut out the outer fistula sections in the region of the openings in a large-scale manner, e.g. in a funnel shape to allow healing of the fistula from within. To remove the fistula wall a variety of curettes is required because they quickly dull. The procedure is time-consuming and requires a high concentration of executive personnel so that the fistula wall is completely removed. Remains of the fistula wall in the fistula tract, new inflammations may arise, which often can not cure the fistula satisfactorily.
    The object of the invention is to provide an advantageous instrument of the type mentioned, which allows a reliable and easy removal of body tissue from a fistula tract.
    According to the invention, this is achieved by an instrument having the features of claim 1.
    The instrument according to the invention has a guide rod for passage through the fistula tract. In addition, a tubular cutting tool can be pushed onto the guide rod. The cutting tool has a rear guide portion for slidably guiding the cutting tool on the guide rod and a front cutting portion. At a front end of the cutting portion, the cutting edge is formed.
    The inner diameter of the cutting portion is larger than the outer diameter of the guide rod to form a receiving cavity for receiving separated body tissue.
    On the one hand, the guide rod serves as the so-called representation of the fistula tract, that is to say that the fistula tract is correspondingly aligned before the cutting process is carried out. The outer diameter of the guide rod is preferably chosen so that the fistula is stretched on the guide rod, i. in that the fistula passage is slightly widened by the introduced guide rod, the fistula wall advantageously bearing against the guide rod over the entire longitudinal extent of the fistula passage. On the other hand, the guide rod also serves to guide the cutting tool along the longitudinal extent of the guide rod. The guide rod could be referred to in the context of the invention as a rod or guide rod. Preferably, the guide rod is straight.
    By the defined guidance of the cutting tool on the guide rod in the direction of the longitudinal center axis of the guide rod, the risk of undesired injuries to the surrounding body tissue can be reduced, since the degree of freedom of the cutting tool with respect to the guide rod advantageously in an axial direction (in the direction of the longitudinal center axis of the guide rod) and is limited to a rotation about the longitudinal center axis of the guide rod. In addition, a removal of the body tissue can be done in a more defined manner.
    Preferably, the cutting edge of the cutting edge of the cutting tool, in an axial view of the cutting tool, on a circle which lies concentric with the longitudinal center axis of the guide rod when slid onto the guide rod cutting tool. By rotating the cutting tool about the longitudinal central axis of the guide rod and with simultaneous forward movement in the direction of the longitudinal central axis, the fistula wall surrounding the fistula can be separated as a geometrically defined hollow cylinder from the surrounding body tissue.
    The cutting edge may be circular throughout, i.e. the cutting edge of the cutting edge is then circular. For example, it would also be conceivable and possible for the cutting edge to have a serrated edge. Even with a serrated edge, the cutting edge of the cutting edge, seen in an axial view of the cutting tool, preferably on a circle.
    The tubular cutting tool could also be referred to as a cutting tube. Cutting tubes for use in medical applications are known in principle, for example for laparoscopic hysterectomy and Myomenukleation. In the field of minimally invasive surgery, so-called morcellators are known, which serve to break up large, to be removed from the inside of the body, tissue parts or organs. In this case, a motor-driven cutting tube of the Morcellators surrounded by a protective tube rotates at high speed. The shredded tissue pieces are transported through the inner cavity of the cutting tube to the outside.
    The guide section advantageously has a length of at least 1 cm, preferably of at least 3 cm, relative to the direction of the longitudinal central axis of the cutting tool, over which the sliding guide of the cutting tool takes place on the guide rod. For example, the length may be in the range of 5 cm. As a result, a stable guidance of the cutting tool can be achieved.
    Preferably, the instrument has a counter-holding piece, which is connectable to and detachable from a front end of the guide rod, wherein the counter-holding piece has a displacement of the cutting tool on the guide rod limiting stop for the cutting edge. After passing the guide rod through the fistula, the counter-piece can be connected by the medical staff by means of a medical cutlery with the guide rod. Suitable compounds include e.g. Snap connections or other known in the art fasteners. Particularly preferred is a screw connection.
    By the counter-piece, the body tissue to be removed is supported on the opposite side of the blade, the limiting stop for the blade in particular allows a clean end cut, i. a complete separation of the fistula wall or the body tissue to be removed. Preferably, the diameter of the limiting abutment is greater than the circle diameter of the circle on which lies the cutting edge of the cutting edge to prevent inadvertent pulling of the counterhold piece into the fistula.
    Advantageously, the instrument for introducing the guide rod into the fistula tract has a rod-shaped and bendable insertion aid which can be connected to and detachable from a front end of the guide rod. The introducer could also be referred to as an introducer and conveniently is easily plastically deformable by hand. As a result, in particular, curved fistula tracts can be probed, whereby the guide rod can be introduced into such a curved fistula tract while straightening the fistula tract. The diameter of the introducer is conveniently smaller than the diameter of the fistula tract.
    The guide rod thus advantageously has a greater flexural rigidity than the insertion aid, so that the insertion aid is lighter, in particular substantially lighter, bendable than the guide rod. The guide bar is preferably not deformed when using the instrument. This makes it possible to maintain the coaxiality of the cutting edge of the cutting tool with respect to the guide rod during the cutting process. The outer diameter of the guide bar is favorably more than 3 mm. Thus, a sufficient stability against deflections of the guide rod for concentric guidance of the cutting edge can be achieved.
    It is advantageous if the guide rod has a handle for facilitating the holding of the guide rod by the operator, which, in one
    Cross-section seen orthogonal to the longitudinal central axis of the guide rod, having a deviating from the circular outer contour. Thereby, for example, the rotation of the guide rod, e.g. for screwing on the counterhold piece or the insertion aid.
    The guide rod preferably has a length of at least 6 cm, more preferably of at least 15 cm.
    The cutting tool conveniently has a control handle for facilitating the operation of the cutting tool, which, viewed in a cross section orthogonal to the longitudinal axis of the cutting tool, has a different outer contour from the circular shape. With the operating handle, the cutting tool can be rotated relative to the guide rod to perform the cutting movement. The movement of the cutting tool in the direction of the longitudinal center axis of the guide rod can be facilitated.
    Advantageously, the length of the cutting portion of the cutting tool measured in the direction of the longitudinal center axis of the cutting tool, and thus the length of the formed receiving cavity when the cutting tool is pushed onto the guide rod, is at least 2 cm, preferably at least 4 cm, more preferably at least 6 cm. The length of the cutting section, and thus the length of the receiving cavity formed in the state of the cutting tool pushed onto the guide rod, advantageously corresponds at least to the length of the fistula wall of the fistula tract to be removed.
    Preferably, the difference between the circle diameter of the circle on which the cutting edge of the cutting edge, in an axial view of the cutting tool, and the outer diameter of the guide rod is at least 1 mm, more preferably at least 2 mm. In this way, a sleeve-shaped fabric region of the corresponding thickness can be removed when the fistula tract is adjacent to the guide rod.
    Further features and details of the invention will be explained with reference to the embodiment shown in the figures of an instrument for removing body tissue from a fistula tract and by means of exemplary schematic illustrations of the separation of body tissue in the area of an anal fistula. Show it:
    1 is an isometric view of an instrument according to the invention in the delivery condition;
    FIG. 2 shows the instrument according to FIG. 1 with the protective cap removed from the cutting tool; FIG.
    FIG. 3 shows a side view of the instrument according to FIG. 2 without protective cap; FIG.
    FIG. 4 shows a detailed view of the insertion aid connected to the guide rod according to FIG. 3; FIG.
    FIG. 5 shows the insertion aid removed from the guide rod; FIG.
    6 shows a detailed view of the counter-retaining piece screwed onto the guide rod;
    FIG. 7 shows a longitudinal center section of the cutting tool (sectional plane parallel to the plane of the drawing in FIG. 3); FIG.
    8 shows an isometric view of the cutting tool pushed onto the guide rod, including the counterhold piece;
    FIG. 9 is a side view of a front portion of the instrument of FIG. 8; FIG. FIG. 10 shows a longitudinal center section through the region of the instrument shown in FIG. 9; FIG.
    FIG. 11 shows the longitudinal center section analogous to FIG. 10 with the cutting tool advanced to the stop; FIG.
    FIG. 12 shows the section A-A according to FIG. 9; FIG.
    13 is a schematic sectional view of a fistula in the region of the anus;
    14 to 16 are schematic representations of various steps for the separation of body tissue in the region of the fistula tract according to FIG. 13, and FIG. 17 shows the detail B according to FIG. 16 in an enlarged view.
    The instrument for removing body tissue from a fistula tract 1 has a tubular cutting tool 10. The shape of the cutting tool 10 could also be referred to as sleeve-shaped. The cutting tool 10 is formed in the embodiment of a first pipe section 18 and a second pipe section 19 which are rigidly connected to each other, preferably cohesively, more preferably by means of adhesive 21, for example, a known two-component adhesive. The connection could for example also be done by compression. The cutting tool 10 thus consists in the embodiment at least substantially (that is, apart from the adhesive 21) made of metal. However, this is only one possible embodiment of a cutting tool 10 according to the invention. For example, it could also be manufactured in one piece from a single blank, in particular from metal. In other embodiments, the second pipe section 19 could be made of plastic and the first pipe section 18 made of metal or ceramic, for example.
    The cutting tool 10 has a, relative to a cutting direction 24 of the cutting tool 10, front cutting portion 11, at the front end of a cutting edge 12 is formed by the wall of the cutting tool 10 tapers at the front end of the cutting portion 11 to a cutting edge. The cutting edge lies in an axial view of the cutting tool 10, i. orthogonal to the longitudinal central axis 23 of the cutting tool 10 seen on a circle, cf. Fig. 12. In the embodiment, the cutting edge of the cutting edge 12 is over its entire circumference in a plane, but could for example also have a serrated edge.
    The circle diameter 22 of the circle on which the cutting edge of the cutting edge 12 is located is less than 1 cm, in the embodiment, the circular diameter 22 is 0.6 cm. The circle diameter 22 can be selected by selecting a corresponding cutting tool 10, depending on the cross section of the fistula passage 1 or the thickness of the fistula wall.
    The cutting edge 12 has in the embodiment a truncated cone-shaped
    Outside on, see. Fig. 7 and 8, but could for example also be designed inside or bevelled on both sides. In the delivery state, the protective cap 60 of the instrument protects the cutting edge 12 against contamination or damage, cf. Fig. 1.
    The cutting tool 10 has, with respect to the cutting direction 24, a rear guide portion 16 for slidably guiding the cutting tool 10 on the guide rod 30 to be explained in more detail. Over the entire axial extent of the guide portion 16, the inner diameter 15 of the guide portion 16 is smaller than the inner diameter 13 of the cutting portion 11 over the entire axial extent of the cutting portion 11, see. Fig. 7. In a transition region between the cutting portion 11 and the guide portion 16 is conveniently a countersink (= chamfer) 20 is provided, which facilitates the sliding of the cutting tool 10 on the guide rod 30. Such a countersink can also be omitted.
    To facilitate the handle of the cutting tool 10 for the operator, the cutting tool 10 on the outside of the guide portion 16 conveniently on a control handle 17 to facilitate the operation of the cutting tool 10. Viewed in a cross section orthogonal to the longitudinal central axis 23 of the cutting tool 10, the operating handle 17 has a deviating from the circular outer contour. In the exemplary embodiment, the operating handle 17 is formed by two opposite flat areas, cf. Fig. 3.
    The guide rod 30 is elongated and straight. It advantageously has a circular cross-section over most of its longitudinal extent, cf. Fig. 3 and Fig. 12. The length of the guide rod 30 is 25 cm in the embodiment.
    The cutting tool 10 can be pushed onto the guide rod 30, wherein the guide portion 16 of the cutting tool 10 is guided with its inner surface 25 on the outer surface 36 of the guide rod 30 slidably. The inner surface 25 of the rear guide portion 16 thus cooperates to form a sliding guide of the cutting tool 10 on the guide rod 30 with the outer surface 36 of the guide rod 30. The inner surface 25 of the guide portion 16 is preferably formed cylindrical barrel-shaped.
    In the pushed onto the guide rod 30 state of the cutting tool 10, the cutting tool 10 and the guide rod 30 are coaxial, i. the longitudinal central axis 23 of the cutting tool 10 and the longitudinal central axis 35 of the guide rod 30 lie on a common straight line. Also, the circle on which the cutting edge of the cutting edge 12 is located when pushed onto the guide rod 30 state to the guide rod 30 coaxially, see. Fig. 12.
    The guide rod 30 is made in the embodiment of metal. It is virtually not deformed during use. Thereby, the coaxiality of the cutting edge 12 with respect to the guide rod 30 during the cutting process can be ensured. Thus, a uniform separation of the fistula wall over the entire longitudinal extent of the fistula passage 1 can be achieved, as explained in more detail below.
    The inner diameter 15 of the guide portion 16 and the outer diameter 34 of the guide rod 30 together form a clearance fit to form a sliding guide of the cutting tool 10 on the guide rod 30. The difference of the inner diameter 15 of the guide portion 16 of the cutting tool 10 and the outer diameter 34 of the guide rod 30 is advantageously less than 0.2 mm (at least over the majority of the longitudinal extent of the guide rod 30, over which this is conveniently circular-cylindrical).
    At the rear end of the guide rod 30, a handle 33 for facilitating the holding of the guide rod 30 is preferably formed by the surgeon. Seen in a cross section orthogonal to the longitudinal central axis 35 of the guide rod 30, the guide rod 30 in the region of the handle 33 one of the
    Circular shape deviating outer contour. In the exemplary embodiment, the handle 33 is formed by two opposite flat points on the guide rod 30, see. Fig. 3.
    Both the handle 33 of the guide rod 30, as well as the operating handle 17 of the cutting tool 10 could in other embodiments according to the invention, other than the formed by the flats of the embodiment outer contour, e.g. a star-shaped outer contour.
    The inner diameter 13 of the cutting portion 11 of the cutting tool 10 is greater than the outer diameter 34 of the guide rod 30 over the entire axial extent of the cutting portion 11. When slid on the guide rod 30 cutting tool 10 is thereby formed a receiving cavity 14 for receiving separated body tissue 5. This receiving cavity 14 is thus bounded inwardly by the outer surface 36 of the guide rod 30 and outwardly by the inner surface 25 of the cutting portion 11 of the cutting tool 10. The receiving cavity 14 is thus sleeve-shaped or tubular and open to the front (with respect to the cutting direction 24), cf. 10 and 12. The receiving cavity 14 connects directly to the cutting edge of the cutting edge 12. The circle diameter 22 of the circle on which the cutting edge of the cutting edge 12 lies corresponds to the inner diameter 13 of the cutting portion 11 of the cutting tool 10 in the exemplary embodiment.
    The difference between the inner diameter 13 of the cutting portion 11 and the outer diameter 34 of the guide rod 30 is preferably at least 1 mm, more preferably at least 2 mm.
    The outer diameter of the cutting tool 10 is constant over the cutting portion 11 and at least not greater than the guide portion 16 in the cutting section 11th
    The instrument further comprises a rod-shaped and bendable insertion aid 50, which can be connected to and detachable from a front end of the guide rod 30. For connection to the guide rod 30, the insertion aid 50 in the exemplary embodiment has a threaded bore (not visible in the figures).
    At the front end of the guide rod 30, a corresponding threaded pin 32 is formed, see. Fig. 5. At the front end of the insertion aid 50, this has a rounded head 53, which facilitates the insertion of the insertion aid 50 in the fistula passage 1. When inserted into the fistula tract 1, the insertion aid 50 can follow the course of the fistula tract 1 by virtue of its flexibility, or a certain straightening of the fistula tract 1 can already take place when the insertion aid 50 is inserted into the fistula tract 1.
    To facilitate the screwing or unscrewing of the insertion aid 50 from the front end of the guide rod 30, the insertion aid 50 may have a recess 52, which facilitates the manipulation by means of a medical cutlery. In the delivery state, the insertion aid 50 is advantageously already connected to the guide rod 30 in order to avoid an additional operation for screwing on the insertion aid 50, cf. Fig. 1.
    The instrument further comprises a counter-holding piece 40, which is connectable to and detachable from the guide rod 30, cf. Fig. 6. Analogous to the insertion 50, the counter-piece 40 has a (not visible in the figures) threaded bore which is connectable to the threaded pin 32 at the front end of the guide rod 30 by screwing and removable from this again.
    The counter-retaining piece 40 has a stop 43, which limits the displacement path of the cutting tool 10 on the guide rod 30 in the cutting direction 24. In as far as possible on the guide rod 30 in the cutting direction 24 shifted state of the cutting tool 10 abuts the blade 12 on the stopper 43, see. Fig. 11. I o
    The backing piece 40 may include a recess 42 to facilitate the screwing of the backing piece 40 within the body during the procedure. The surgeon may remove the backing piece 40, e.g. hold by means of tweezers and rotate the guide rod 30 so as to make the connection with the guide rod 30.
    Preferably, the cutting edge of the cutting edge 12 abuts circumferentially on the stop 43 during displacement of the cutting tool 10 in order to enable a clean separation at the end of the displacement path of the cutting tool 10 on the guide rod 30, cf. Fig. 11.1m embodiment, the diameter 44 is only slightly larger than the circle diameter 22, but could be significantly larger in other embodiments of the invention.
    In the following, the process of removing body tissue from a fistula tract 1 in the region of the anus will be explained with reference to FIGS. 13 to 17. The fistula tract 1 forms a channel between the rectum 3 and the body surface 4. The course of the fistula tract 1 is not straight, as is generally to be found in practice, cf. Fig. 13. In the example shown, the length of the fistula tract is about 5 cm. The fistula wall bounding the fistula passage 1, not separately drawn in the figures, is an epithelial lining, i. it is formed by a kind of thin skin, the thickness of which is usually in the range of 0.5 mm to 1 mm.
    First, the guide rod 30 is inserted into the fistula passage 1 by means of the insertion aid 50. The fistula passage 1 is straightened by the inserted guide rod 30, cf. It should be noted that the outer diameter 34 of the guide rod 30 is favorably chosen to be larger than the diameter of the fistula passageway 1. As a result, the fistula wall of the fistula passageway 1 lies completely against the guide rod 30 in the fully inserted state of the guide rod 30.
    In a next step, the insertion aid 50 is removed from the guide rod 30 I Η. For this, the insertion aid 50, e.g. with a medical instrument, e.g. tweezers, rotationally held while the guide rod 30, e.g. is rotated by means of the handle 33, opposite the fistula passage 1 and the insertion aid 50. After unscrewing and removing the insertion aid 50, the counter-retaining piece 40 is connected to the front end of the guide rod 30, which is located inside the body. Also for this purpose, the guide rod 30 can be conveniently rotated by means of the handle 33 against the retained counter-holding piece 40. Conveniently, in the condition connected to the guide bar 30, the counterpart piece 40 also forms a kind of anchor to prevent the front end of the guide bar 30 from slipping into the fistula passage 1 during the cutting operation.
    In the subsequent step, the cutting tool 10 is pushed onto the guide rod 30, see. Fig. 15. During the following cutting operation, the cutting tool 10 is conveniently rotated in addition to the movement in the cutting direction 24 relative to the guide rod 30 to allow a clean cut. The already separated during the cutting process body tissue 5 is gradually absorbed in the receiving cavity 14 between the cutting portion 11 of the cutting tool 10 and the guide rod 30, see. FIGS. 16 and 17.
    At the end of the displacement path of the cutting tool 10, the cutting edge 12 of the cutting portion 11 abuts the stop 43 of the counter-piece 40. In the receiving cavity 14 is the body tissue 5 completely separated from the surrounding tissue of the body, which covers the epithelial lining, i. the fistula wall of the fistula duct 1.
    In a last, not separately shown step, the guide rod 30 is led out with the cutting tool 10 and the separated body tissue 5 from the body. The counter-piece 40 may be removed beforehand, in particular if a counter-holding piece 40 is used, whose diameter 44 is significantly larger than the outer diameter of the
    Cutting tool 10 is. Alternatively, particularly if the diameter of the mating piece 40 is approximately equal to the circle diameter 22, the mating piece 40 could be pulled out of the body of the patient along with the guide rod 30 and the cutting tool 10.
    After removal of the fistula wall there is fresh, blood-perfused body tissue in the area of the Fssteigangs 1, now extended in its cross-section. The perfused tissue allows the fist to grow together and heal! After the procedure, in the embodiment shown, the difference between the circle diameter 22 of the circle is aut to which the cutting edge of the cutting edge 12 is located and the outside diameter 34 of the guide rod 30 2 mm. Thereby, the fistula wall (having, for example, a thickness of 0.5 mm, for example) and body tissue (z, B, having a thickness of 0.5 mm) adjoining the fistula wall can be removed as a whole over the entire longitudinal extension of the fistula passage 1. In other words, sleeve-shaped body tissue, in the case of an exercise case with a wall thickness of 1 mm, can be removed with the instrument shown.
    Depending on the length and diameter of the fistula tract to be treated and the thickness of the Hsteiwand instruments with appropriate dimensions-vorgesehen.
    Key to the reference numbers: 1 fistula 30 guide rod 2 anus 31 longitudinal central axis 3 rectum 32 threaded pin 4 body surface 33 handle 5 separated body tissue 34 outer diameter 35 longitudinal central axis 10 cutting tool 36 outer surface 11 cutting section 12 cutting edge 40 counter piece 13 inner diameter 42 recess 14 receiving cavity 43 stop 15 inner diameter 44th Diameter 16 Guide section 17 Operating handle 50 Insertion aid 18 First tube section 52 Recess 19 Second tube section 53 Head 20 Countersink 21 Adhesive 60 Protective cap 22 Circular diameter 23 Longitudinal center axis 24 Cutting direction 25 Inner surface
    权利要求:
    Claims (10)
    [1]
    An instrument for removing body tissue from a fistula tract (1) having a cutting tool (10) having a cutting edge (12), characterized in that the instrument further comprises a guide rod (30) for passing through the fistula tract (1) and the cutting tool (10) is tubular and can be pushed onto the guide rod (30) and has a rear guide section (16) for displaceably guiding the cutting tool (10) on the guide rod (30) and a front cutting section (11) a front end of the cutting edge (12) is formed and the inner diameter (15) for forming a receiving cavity (14) for receiving separated body tissue (5) is greater than the outer diameter (34) of the guide rod (30).
    [2]
    2. Instrument according to claim 1, characterized in that the cutting edge of the cutting edge (12) in an axial view of the cutting tool (10) lies on a circle, which when pushed onto the guide rod (30) cutting tool (10) concentric with the guide rod (30 ) lies.
    [3]
    3. Instrument according to claim 2, characterized in that the circle has a circular diameter (22) of at most 1 cm.
    [4]
    4. Instrument according to one of claims 1 to 3, characterized in that the instrument comprises a counter-holding piece (40) which is connectable to and detachable from a front end of the guide rod (30), wherein the counter-holding piece (40) a the displacement of the cutting tool (10) on the guide rod (30) limiting stop (43) for the cutting edge (12).
    [5]
    5. Instrument according to one of claims 1 to 4, characterized in that the guide section (16) relative to the direction of the longitudinal central axis (23) of the cutting tool (10) has a length of at least 1 cm, preferably of at least 3 cm.
    [6]
    6. Instrument according to one of claims 1 to 5, characterized in that the instrument for inserting the guide rod (30) in the fistula passage (1) has a rod-shaped and bendable insertion aid (50), which with a front end of the guide rod (30). connectable and detachable from this.
    [7]
    7. Instrument according to one of claims 1 to 6, characterized in that the guide rod (30) has a handle (33) for facilitating the holding of the guide rod (30) by the operator, which, in a cross section orthogonal to the longitudinal central axis (35). The cutting tool (10) has an operating handle (17) for facilitating the operation of the cutting tool (10), which, in a cross section orthogonal to the longitudinal central axis (23). of the cutting tool (10) has a deviating from the circular outer contour.
    [8]
    8. Instrument according to one of claims 1 to 7, characterized in that in the on the guide rod (30) pushed state of the cutting tool (10) formed receiving cavity (14) relative to the direction of the longitudinal central axis (23) of the cutting tool (10) Length of at least 2 cm, preferably at least 4 cm.
    [9]
    9. Instrument according to one of claims 1 to 8, characterized in that the guide rod (30) has a length of at least 6 cm, preferably of at least 15 cm.
    [10]
    10. Instrument according to one of claims 1 to 9, characterized in that the difference between the inner diameter (13) of the cutting portion (11) and the outer diameter (34) of the guide rod (30) is at least 1 mm, preferably at least 2 mm.
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    同族专利:
    公开号 | 公开日
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    US20170014150A1|2017-01-19|
    AT516604B1|2016-07-15|
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    US5643305A|1994-11-18|1997-07-01|Al-Tameem; Moshin|Device for excision of a fistula|
    ES2116914B1|1996-05-14|1999-03-01|Palazon Hernandez Jesus Maria|PERIANAL FISTULES RESECTOR.|
    CA2606108A1|2005-05-02|2006-11-09|Resqmedical Ltd.|Self-withdrawing catheter for injecting into body passageways and kit containing same|DE102020203307A1|2020-03-16|2021-09-16|Klaus Friedhoff|Surgical tool used to remove fistulas|
    法律状态:
    2021-03-15| MM01| Lapse because of not paying annual fees|Effective date: 20200713 |
    优先权:
    申请号 | 申请日 | 专利标题
    ATA460/2015A|AT516604B1|2015-07-13|2015-07-13|Instrument for removing body tissue from a fistula tract|ATA460/2015A| AT516604B1|2015-07-13|2015-07-13|Instrument for removing body tissue from a fistula tract|
    EP16172260.8A| EP3117786A1|2015-07-13|2016-05-31|Instrument for removing body tissue from a fistula|
    US15/208,797| US20170014150A1|2015-07-13|2016-07-13|Instrument for removing body tissue from a fistulous tract|
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