DE102011000928A1 - Surgical instrument, particularly endoscopic tubular shaft instrument, has tool element that is pivotally supported on bearing shaft, where tool element is fixed with fastening unit to instrument - Google Patents

Abstract

The surgical instrument (10) has a tool element (26,28) that is pivotally supported on a bearing shaft (46), where the tool element is fixed with a fastening unit (56) to the instrument. The fastening unit has a connecting element and two contact elements (62), where the contact elements are held at the connecting element and are displaceable relative to each other from an installing position, in which the bearing shaft is axially movable relative to the instrument in a fastening position, in which the bearing shaft is axially movably held at the instrument. An independent claim is also included for a method for manufacturing a surgical instrument.

Description

The present invention relates to a surgical instrument having at least one tool element pivotably mounted on a bearing shaft, which bearing shaft is fixed to the instrument by means of a fastening device.

Furthermore, the present invention relates to a method for producing a surgical instrument having at least one tool element pivotably mounted on a bearing shaft, which bearing shaft is fixed to the instrument with a fastening device.

Surgical instruments of the type described above are known, for example in the form of instruments comprising two abutting branches, which are connected by means of a locking screw. An example of this are commercially available scissors and forceps. Furthermore, such instruments are also known in the form of endoscopic instruments which have a shank on which one or more tool elements, for example pivotable, are mounted in the region of a distal end. Especially with very small shank diameters and thus corresponding filigree tool elements, the installation of the instrument, especially the tool elements, but designed as difficult.

It is therefore an object of the present invention to improve a surgical instrument and a method of the type described above so that the instrument can be made easier.

This object is achieved according to the invention in a surgical instrument of the type described above, that the fastening device comprises a connecting member, a first contact element and a second contact elements, which holding elements held on the connecting member and axially relative to each other by a landing position in which the bearing shaft relative to the instrument is movable toward each other in the direction of a longitudinal axis defined by it to be displaced into a fastening position in which the bearing shaft is held immovably on the instrument axially.

The development proposed according to the invention makes it possible in a simple manner to fix the at least one tool element on the instrument quickly, safely and in a defined manner. Thus, the tool element can be brought with a receptacle for the bearing shaft in the desired position and then, for example, the bearing shaft can be passed through the recording of the tool element. By moving the abutment elements toward each other, the connecting member and thus at the same time the bearing shaft is fixed in the desired manner on the instrument. The fastening device can be used in particular in instruments which are essentially formed by two sectors mounted pivotably against each other, but also in endoscopic instruments with elongate shanks, on which the at least one tool element is pivotably mounted.

It is favorable if the instrument comprises a shaft and if the at least one tool element is pivotably mounted on the shaft. This makes it possible to easily form endoscopic instruments, in particular with elongated straight and single and multiple bent shafts.

It is advantageous if the bearing shaft is arranged at a distal end or in the region of a distal end of the instrument. This is particularly favorable for the formation of endoscopic instruments for use in minimally invasive surgery.

The fastening device can be particularly simple and compact form when the connecting member comprises a link portion which forms the bearing shaft. In other words, the bearing shaft forms part of the connecting member.

In order to reduce the number of parts required for the formation of the instrument, it is advantageous if the connecting member and the bearing shaft are integrally formed. Thus, it can also be easily prevented that the connecting member and the bearing shaft separate from each other.

Preferably, the abutment elements lie in the attachment position directly or indirectly on an outer side of the shaft. In this way, the bearing shaft can be defined defined on the shaft. Indirectly, the abutment elements can be present in particular if, for example, they hold an insulating element on the shaft, for example a plastic cover in the region of a bearing receptacle for the bearing shaft and the at least one tool element. For example, different temperature expansions of the shaft and of an insulating layer or coating surrounding it, in particular due to heat development in instruments designed for high-frequency surgery as a result of application of current, can cause the insulation layer to come loose in the region of the tool element receptacle on the shaft, for example in that the plastic expands and loses adhesion to the shaft in this way. The abutment elements then prevent the lifting of the insulation layer from the shaft.

Preferably, the abutment elements are held in the fastening position under bias against an outer side of the shaft. This can also ensure that, for example, in the region of a bearing shaft receiving, which comprises two spaced apart, substantially parallel arms, these arms can not move away from one another in an undesirable manner. In addition, by biasing the abutment elements, a bias of the parts held together with the fastener can be applied.

According to a preferred embodiment of the invention, a biasing means for holding the abutment elements in the mounting position can be provided under pretension against an outer side of the shaft. The biasing means makes it particularly easy to bias the abutment members against the shaft.

It is advantageous if the pretensioning device comprises at least one prestressing element for holding the contact elements in the fastening position under prestress against an outer side of the shaft. By means of the biasing element, it is possible to apply a desired and optionally required pretension in a very targeted manner.

The instrument can be made particularly compact if the first or the second contact element form the at least one biasing element. It would also be conceivable that both contact elements are completely or partially formed in the form of a biasing element. You can do so a dual function, namely the adhesion of the link under simultaneous bias.

Preferably, the at least one biasing element is at least partially resilient. Thus, a biasing force can be exerted on the contact elements in a simple and defined manner.

It is favorable if the at least one biasing element comprises at least one resilient retaining section. Thus, by targeted formation of the retention section, the desired biasing force can be exerted on the abutment elements.

In order to obtain a particularly compact construction after installation of the instrument, it is advantageous if the first and / or the second contact element has a shank contact surface which is shaped corresponding to an outer side of the shank. It can thereby be achieved that an outer diameter of the shank in the region of the abutment elements is not substantially increased by the abutment elements, if they rest only on the outside of the shank and do not engage in a recess of the same in whole or in part.

It is particularly advantageous if the shank contact surface bears flatly or substantially flat against the outside of the shank. This makes it possible that only the shaft increases by the thickness of the contact element. Furthermore, contact forces can also be introduced over a large area onto the shaft, which permanently assures a sufficient stability of the instrument.

In particular, in the case of shanks that are cylindrical or substantially cylindrical in shape, it is expedient for the shank contact surface to be concavely curved in the direction of the shank. The shank contact surface may preferably be a hollow-cylindrical or substantially hollow-cylindrical surface section.

According to a preferred embodiment of the invention can be provided that the first and / or the second contact element are mounted relative to the link on this at least in the contact position displaceable. It can therefore be displaceable relative to the connecting member, the first, the second or even both contact elements, depending on the design of the instrument. To provide two movable contact elements, in particular has the advantage that an even better adaptation of the fastening device to the instrument is possible.

It is advantageous if the first contact element and the connecting member are firmly connected to each other. This makes it possible, for example, to perform the first contact element with the connecting member by a receptacle of the tool element and optionally a shaft of the instrument, wherein the first contact element simultaneously forms a stop for positioning of the bearing shaft. In addition, the risk is minimized that the first contact element can come off the link.

Advantageously, the first contact element and the connecting member are integrally formed. In this way, a stability of the instrument can be increased and minimize the number of parts required to form the fastening device.

In order to ensure that the bearing shaft can not inadvertently disengage from the instrument, it is advantageous if the fastening device comprises a securing device for preventing movement of the first and the second abutment element away from one another. In other words, it is possible that the first and second Abutment elements can only be moved towards each other and that is prevented by the securing device that contact elements can move away from each other again and then in the worst case, the bearing shaft can be detached from the instrument.

Preferably, the first and / or the second contact element relative to the connecting member only in one direction to the respective other contact element and not against the action of the securing device on the connecting member displaceable. This embodiment facilitates the installation of the instrument, because as soon as the first and / or the second contact element are in engagement with the connecting member that the securing device acts, the first and / or the second contact element can not be easily detached from the connecting member. This makes it easy to prevent one or both elements from being lost during assembly of the instrument. In addition, it can also be done in a simple manner, a pre-assembly, that is, the parts of the instrument can be connected to each other, but without having to be brought into their final working position.

The construction of the instrument is particularly simple if the securing device comprises at least one first securing element and at least one second securing element engagable with the at least one first securing element, if the connecting element comprises the at least one first securing element and if the first and / or the second contact element the at least one second securing element comprises.

In principle, it would be conceivable to form at least one of the securing elements in the form of a structured surface or by the surface of the connecting member or the contact elements structuring profile. Preferably, the at least one first and the at least one second securing element in the form of mutually cooperating locking elements are formed. This is to be understood in particular as meaning that the two securing elements can be brought into engagement with one another by latching, which, however, does not require that both securing elements must be movably arranged or formed. In particular, only one of the two locking elements can have a certain mobility.

The construction of the securing device can be further simplified if the at least one second securing element is designed pointing in the direction of or substantially in the direction of the longitudinal axis. This makes it possible, for example, to cooperate with corresponding projections or recesses on the connecting member, which in particular can define first securing elements.

In a particularly simple manner, the first and second securing members can be engaged with each other when the at least one second securing element or at least one free end thereof is resiliently mounted in a direction parallel or substantially parallel to a longitudinal axis defined by the connecting member. For example, it may be connected to or integrally formed with a resilient portion which allows movement in the manner indicated. Of course, optionally a movement of the securing elements in a direction perpendicular to the defined direction would be conceivable and depending on the design of the instrument advantageous.

According to a further preferred embodiment of the invention it can be provided that the first and / or the second contact element comprises in a direction parallel or substantially parallel to the longitudinal axis at least one elastically resilient retaining element which carries or forms a second securing element. This embodiment basically allows a separation of the functions of the mutually engaging securing elements and a retaining element which carries or forms the second securing element. Thus, in particular, the functions of securing and retaining can be structurally separated from one another.

A particularly simple mounting of the tool elements can be achieved in that the first and / or the second contact element has an opening which passes through the connecting member in the fastening position. Thus, the first and / or the second contact element can be easily produced separately from the connecting member and bring by inserting the connecting member in the respective opening with the connecting member into engagement.

It is advantageous if at least two retaining elements are provided, which separates an outgoing from the opening incision from each other. Thus, the two retaining elements can deform independently, if necessary and desired.

The instrument can be produced particularly simply if the incision extends in the radial direction away from the aperture.

It may also be advantageous if the incision extends at least in sections in the circumferential direction. In particular, temperature fluctuations can be compensated in this way be without the risk that the fastening device can solve. Temperature variations usually occur with surgical instruments whenever they are used multiple times. After each use, they usually have to go through a sterilization process in which large temperature fluctuations occur.

An example desired spring action of the retaining elements can be improved if the incision is formed one or more times curved. These may be bends that lie in a plane or extend in a curved surface.

Preferably, a plurality of first, formed in the form of teeth securing elements are provided, which form a safety toothing. Such a can be produced, for example, in a simple manner on a rod-shaped connecting member. This can basically define a round or square cross-section.

It is advantageous if each tooth comprises a retaining surface and a slide-on surface, when the retaining surface points substantially in the direction of the contact element, which is not engaged with the securing toothing, and if the sliding surface points in substantially the opposite direction. This configuration of the teeth of the securing toothing makes it possible for contact elements on the connecting member to be moved only in one direction, namely via the tooth, in that they first contact the sliding surface, via this sliding and then with their second securing elements on the retaining surface hit a tooth and are prevented from moving back to the starting position.

It is advantageous if the teeth define on an outer side of the connecting link at least one row of teeth extending parallel to the longitudinal axis. Such a can be produced easily. In addition, it can be brought into precisely defined positions and thus fixed relative to the connecting member with her investment elements.

Preferably, two or more rows of teeth are provided. For example, four rows of teeth may be provided, each pointing in pairs away from the link in opposite directions.

The manufacture of the surgical instrument can be simplified in particular if the teeth of each row of teeth are arranged equidistantly.

Conveniently, the teeth of circumferentially adjacent rows of teeth are arranged axially offset from one another. This has the particular advantage that, as effectively as possible, a tooth spacing defined between two teeth can be halved, for example. This can be achieved, for example, in that the teeth of a row of teeth adjacent in the circumferential direction are each arranged axially at the level of the space between two teeth of the other row of teeth. If, for example, securing members on the contact element are identically formed and / or arranged, which engage with one or the other row of teeth, their retention positions, in which they rest against retaining surfaces of the teeth, can be set even more precisely. In other words, the number of possible detent positions can be doubled or multiplied even further.

The instrument is particularly easy to manufacture if the connecting member is mirror-symmetrical to the at least one mirror plane containing the longitudinal axis. There may also be two or more such mirror planes.

The manufacture and assembly of the surgical instrument can be further simplified if the first and / or the second contact element are circular, substantially circular, oval, substantially oval, polygonal or substantially polygonal. Particularly preferred are rectangular or square bearing elements, which have rounded corners and edges.

According to a further preferred embodiment of the invention it can be provided that the first and / or the second abutment element comprise compensating elements, which are elastically deformable in a direction parallel or substantially parallel to the longitudinal axis. The compensating elements can in particular serve the purpose of compensating in a simple manner predetermined minimal grid positions which are formed or defined, for example, by one of the securing toothings described above. They thus serve in particular to compensate for manufacturing tolerances and allow easy adaptation of standardized trained fasteners on instruments and shafts thereof with different dimensions.

Particularly simple and effective manufacturing tolerances and different dimensions can be compensated if the compensation elements are designed in the form of compensation spring elements. In particular, the compensating spring elements can have spring-elastic properties.

It is advantageous if adjacent compensating spring elements are separated from one another by a slot which extends from the edge bordering the respective abutment element in the radial direction or substantially in the radial direction onto the longitudinal axis. The limited by two slots compensating spring elements can then move in the required manner to compensate for manufacturing tolerances and predetermined grids or detent position distances.

According to a further preferred embodiment of the invention it can be provided that the first and / or the second contact element is formed from a wave-shaped profiled body and the wave-shaped profile at least partially defines or forms the compensating spring elements. The wave-shaped profile allows a simple way deformation of the compensating spring elements. If the profiled body is made of a resilient material, the compensating spring elements can thus also have spring-elastic properties in a simple manner.

Tool elements can be stored in a particularly simple and safe manner when the bearing shaft is in the form of a cylindrical rod.

To improve the bearing properties of the bearing shaft, it is advantageous if this carries no securing elements. In other words, it may have a macroscopically smooth outer surface, as is the case, for example, with a cylindrical bearing pin, as provided in commercially available surgical instruments.

It is advantageous if an outer diameter of the connecting member in the region of the bearing shaft is equal to or greater than an outer diameter in the region of the second securing elements. Thus, it can be ensured that the at least one tool element can be mounted on the bearing shaft as far as possible without play, even if it has to be passed through or introduced, for example, through receptacles or apertures on the shaft.

It is advantageous if the bearing shaft defines a bearing shaft longitudinal axis when the shaft defines a shaft axis and when the bearing shaft longitudinal axis is transverse, in particular perpendicular to the shaft axis. Depending on the design of the at least one tool element, it is possible that this can be pivoted, for example, into a position in which it does not protrude beyond a shaft of the instrument. This facilitates the insertion of the instrument, in particular through a minimally invasive access into the body of a patient.

Furthermore, it may be favorable if the instrument comprises a trained at the proximal end of the instrument, formed or connectable with this actuator for introducing an actuating force for moving the at least one tool element. For example, the actuating device may comprise one or two sectors movable relative to one another. The actuating device can in particular be detachably connectable to a shaft of the instrument.

For transmitting an actuating force to the at least one tool element, it is advantageous if the instrument comprises a force transmission member which is movably coupled on the one hand with the at least one pivotable tool element and on the other hand with the actuating device for transmitting an actuating force from the actuating device to the at least one pivotable tool element ,

The structure of the surgical instrument is particularly simple when the force transmission member is slidably and / or rotatably mounted on or in the shaft.

The object stated in the introduction is also achieved in a method for producing a surgical instrument according to the invention in that the fastening device comprises a connecting member, a first contact element and a second contact element, that the contact elements held on the connecting member and relative to each other from a contact position, in which the bearing shaft is axially movable relative to the instrument to be displaced towards each other in the direction of a longitudinal axis defined by it in a fastening position in which the bearing shaft is held immovable axially on the instrument.

With the method according to the invention, surgical instruments can be mounted quickly, reliably and permanently in a simple manner. In particular, the production of disposable instruments can thus be simplified, which saves in particular costs in the production and minimizes the time required for this purpose.

• 1. Chirurgisches Instrument (10) mit mindestens einem auf einer Lagerwelle (46) verschwenkbar gelagerten Werkzeugelement (26, 28), welche Lagerwelle (46) mit einer Befestigungseinrichtung, (56) am Instrument (10) festgelegt ist, dadurch gekennzeichnet, dass die Befestigungseinrichtung (56) ein Verbindungsglied (58), ein erstes Anlageelement (60) und ein zweites Anlageelement (62) umfasst, welche Anlageelemente (60, 62) am Verbindungsglied (58) gehalten und relativ zueinander von einer Anlegestellung, in welcher die Lagerwelle (46) relativ zum Instrument (10) axial bewegbar ist, in Richtung einer von ihr definierten Längsachse (38) aufeinander zu verschiebbar sind in eine Befestigungsstellung, in welcher die Lagerwelle (46) am Instrument (10) axial unbeweglich gehalten ist.
• 2. Chirurgisches Instrument nach Satz 1, dadurch gekennzeichnet, dass das Instrument (10) einen Schaft (12) umfasst und dass das mindestens eine Werkzeugelement (26, 28) am Schaft (12) verschwenkbar gelagert ist.
• 3. Chirurgisches Instrument nach Satz 1 oder 2, dadurch gekennzeichnet, dass die Lagerwelle (46) an einem distalen Ende (24) oder im Bereich eines distalen Endes (24) des Instruments (10) angeordnet ist.
• 4. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das Verbindungsglied (58) einen Verbindungsgliedabschnitt (68) umfasst, welcher die Lagerwelle (46) bildet.
• 5. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das Verbindungsglied (58) und die Lagerwelle (46) einstückig ausgebildet sind.
• 6. Chirurgisches Instrument nach einem der Sätze 2 bis 5, dadurch gekennzeichnet, dass die Anlageelemente (60, 62) in der Befestigungsstellung direkt oder indirekt an einer Außenseite des Schafts (12) anliegen.
• 7. Chirurgisches Instrument nach einem der Sätze 2 bis 6, dadurch gekennzeichnet, dass die Anlageelemente (60, 62) in der Befestigungsstellung unter Vorspannung gegen eine Außenseite des Schafts (12) gehalten sind.
• 8. Chirurgisches Instrument nach einem der Sätze 2 bis 7, gekennzeichnet durch eine Vorspanneinrichtung (114) zum Halten der Anlageelemente (60, 62) in der Befestigungsstellung unter Vorspannung gegen eine Außenseite des Schafts (12).
• 9. Chirurgisches Instrument nach Satz 8, dadurch gekennzeichnet, dass die Vorspanneinrichtung (114) mindestens ein vorspannendes Element (116) umfasst zum Halten der Anlageelemente in der Befestigungsstellung unter Vorspannung gegen eine Außenseite des Schafts (12).
• 10. Chirurgisches Instrument nach Satz 9, dadurch gekennzeichnet, dass das erste oder das zweite Anlageelement (60, 62) das mindestens eine vorspannende Element (116) bilden.
• 11. Chirurgisches Instrument nach Satz 9 oder 10, dadurch gekennzeichnet, dass das mindestens eine vorspannende Element (116) mindestens teilweise federelastisch ausgebildet ist.
• 12. Chirurgisches Instrument nach Satz 11, dadurch gekennzeichnet, dass das mindestens eine vorspannende Element (116) mindestens einen federelastischen Rückhalteabschnitt (118) umfasst.
• 13. Chirurgisches Instrument nach einem der Sätze 2 bis 12, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) eine Schaftanlagefläche (66, 90) aufweist, welche korrespondierend zu einer Außenseite des Schafts (12) geformt ist.
• 14. Chirurgisches Instrument nach Satz 13, dadurch gekennzeichnet, dass die Schaftanlagefläche (66, 90) flächig oder im Wesentlichen flächig an der Außenseite des Schafts (12) anliegt.
• 15. Chirurgisches Instrument nach Satz 13 oder 14, dadurch gekennzeichnet, dass die Schaftanlagefläche (66, 90) in Richtung auf den Schaft (12) hin weisend konkav gekrümmt ist.
• 16. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) relativ zum Verbindungsglied (58) auf diesem mindestens in der Anlegestellung verschiebbar gelagert sind.
• 17. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste Anlageelement (60) und das Verbindungsglied (58) fest miteinander verbunden sind.
• 18. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste Anlageelement (60) und das Verbindungsglied (58) einstückig ausgebildet sind.
• 19. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Befestigungseinrichtung (56) eine Sicherungseinrichtung (106) umfasst zum Verhindern einer Bewegung des ersten und des zweiten Anlageelements (60, 62) voneinander weg.
• 20. Chirurgisches Instrument nach Satz 19, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) relativ zum Verbindungsglied (58) nur in einer Richtung auf das jeweils andere Anlageelement (60, 62) zu und nicht entgegen der Wirkung der Sicherungseinrichtung (106) auf dem Verbindungsglied (58) verschiebbar ist.
• 21. Chirurgisches Instrument nach Satz 19 oder 20, dadurch gekennzeichnet, dass die Sicherungseinrichtung (106) mindestens ein erstes Sicherungselement (104) und mindestens ein zweites, mit dem mindestens einen ersten Sicherungselement (104) in Eingriff bringbares Sicherungselement (102) umfasst, dass das Verbindungsglied (58) das mindestens eine erste Sicherungselement (104) und dass das erste und/oder das zweite Anlageelement (60, 62) das mindestens eine zweite Sicherungselement (102) umfasst.
• 22. Chirurgisches Instrument nach Satz 21, dadurch gekennzeichnet, dass das mindestens eine erste und das mindestens eine zweite Sicherungselement (104, 102) in Form miteinander zusammenwirkender Rastelemente (108, 110) ausgebildet sind.
• 23. Chirurgisches Instrument nach Satz 21 oder 22, dadurch gekennzeichnet, dass das mindestens eine zweite Sicherungselement (102) in Richtung oder im Wesentlichen in Richtung auf die Längsachse (38) hin weisend ausgebildet ist.
• 24. Chirurgisches Instrument nach einem der Sätze 21 bis 23, dadurch gekennzeichnet, dass das mindestens eine zweite Sicherungselement (102) oder zumindest ein freies Ende (100) desselben in einer Richtung parallel oder im Wesentlichen parallel zu einer vom Verbindungsglied (58) definierten Längsachse (38) federnd gelagert ist.
• 25. Chirurgisches Instrument nach einem der Sätze 21 bis 24, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) in einer Richtung parallel oder im Wesentlichen parallel zur Längsachse (38) mindestens ein elastisch federndes Rückhalteelement (98) umfasst, welches ein zweites Sicherungselement (102) trägt oder bildet.
• 26. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) eine Durchbrechung (92) aufweist, die das Verbindungsglied (58) in der Befestigungsstellung durchsetzt.
• 27. Chirurgisches Instrument nach Satz 26, dadurch gekennzeichnet, dass mindestens zwei Rückhalteelemente (98) vorgesehen sind, die ein von der Durchbrechung (92) ausgehender Einschnitt (94) voneinander trennt.
• 28. Chirurgisches Instrument nach Satz 27, dadurch gekennzeichnet, dass sich der Einschnitt (94) in radialer Richtung von der Durchbrechung (92) weg erstreckt.
• 29. Chirurgisches Instrument nach Satz 27 oder 28, dadurch gekennzeichnet, dass sich der Einschnitt (94) mindestens abschnittsweise in Umfangsrichtung erstreckt.
• 30. Chirurgisches Instrument nach einem der Sätze 27 bis 29, dadurch gekennzeichnet, dass der Einschnitt (94) ein- oder mehrfach gekrümmt ausgebildet ist.
• 31. Chirurgisches Instrument nach einem der Sätze 21 bis 30, dadurch gekennzeichnet, dass mehrere erste, in Form von Zähnen (74) ausgebildete Sicherungselemente (104) vorgesehen sind und dass diese Zähne eine Sicherungsverzahnung (84) ausbilden.
• 32. Chirurgisches Instrument nach Satz 31, dadurch gekennzeichnet, dass jeder Zahn (74) eine Rückhaltefläche (76) und eine Aufgleitfläche (78) umfasst, dass die Rückhaltefläche (76) im Wesentlichen in Richtung auf das Anlageelement (60) hin weist, welches nicht mit der Sicherungsverzahnung (84) in Eingriff steht, und dass die Aufgleitfläche (78) im Wesentlichen in entgegengesetzter Richtung weist.
• 33. Chirurgisches Instrument nach Satz 31 oder 32, dadurch gekennzeichnet, dass die Zähne (74) auf einer Außenseite des Verbindungsglieds (58) mindestens eine sich parallel zur Längsachse (38) erstreckende Zahnreihe (80, 82) definieren.
• 34. Chirurgisches Instrument nach Satz 33, gekennzeichnet durch zwei oder mehr Zahnreihen (80, 82).
• 35. Chirurgisches Instrument nach Satz 33 oder 34, dadurch gekennzeichnet, dass die Zähne (74) jeder Zahnreihe (80, 82) äquidistant angeordnet sind.
• 36. Chirurgisches Instrument nach einem der Sätze 31 bis 35, dadurch gekennzeichnet, dass die Zähne (74) von in Umfangsrichtung benachbarten Zahnreihen (80, 82) gegeneinander axial versetzt angeordnet sind.
• 37. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das Verbindungsglied (58) spiegelsymmetrisch zu mindestens einer die Längsachse (38) enthaltenden Spiegelebene ausgebildet ist.
• 38. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) kreisförmig, im Wesentlichen kreisförmig, oval, im Wesentlichen oval, vieleckig oder im Wesentlichen vieleckig ausgebildet sind.
• 39. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) Ausgleichselemente (120) umfassen, welche elastisch in einer Richtung parallel oder im Wesentlichen parallel zur Längsachse (38) verformbar sind.
• 40. Chirurgisches Instrument nach Satz 39, dadurch gekennzeichnet, dass die Ausgleichselemente (120) in Form von Ausgleichsfederelementen (122) ausgebildet sind.
• 41. Chirurgisches Instrument nach Satz 40, dadurch gekennzeichnet, dass benachbarte Ausgleichsfederelemente (122) durch einen Schlitz (124) voneinander getrennt sind, welcher sich ausgehend von einem das jeweilige Anlageelement (60) begrenzenden Rand in radialer Richtung oder im Wesentlichen in radialer Richtung auf die Längsachse (38) hin erstreckt.
• 42. Chirurgisches Instrument nach einem der Sätze 39 bis 41, dadurch gekennzeichnet, dass das erste und/oder das zweite Anlageelement (60, 62) aus einem wellenförmig profilierten Körper gebildet ist und dass das wellenförmige Profil die Ausgleichsfederelemente (122) mindestens teilweise definiert oder bildet.
• 43. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Lagerwelle (46) in Form eines zylindrischen Stabes ausgebildet ist.
• 44. Chirurgisches Instrument nach einem der voranstehenden Sätze, dadurch gekennzeichnet, dass die Lagerwelle (46) keine Sicherungselemente (104) trägt.
• 45. Chirurgisches Instrument nach einem der Sätze 21 bis 44, dadurch gekennzeichnet, dass ein Außendurchmesser des Verbindungsglieds (58) im Bereich der Lagerwelle (46) gleich oder größer als ein Außendurchmesser im Bereich der ersten Sicherungselemente (104) ist.
• 46. Chirurgisches Instrument nach einem der Sätze 2 bis 45, dadurch gekennzeichnet, dass die Lagerwelle (46) eine Lagerwellenlängsachse (38) definiert, dass der Schaft (12) eine Schaftachse (16) definiert und dass die Lagerwellenlängsachse (38) quer, insbesondere senkrecht, zur Schaftachse (16) verläuft.
• 47. Chirurgisches Instrument nach einem der voranstehenden Sätze, gekennzeichnet durch eine am proximalen Ende des Instruments (10) angeordnete, ausgebildete oder mit diesem verbindbare Betätigungseinrichtung (22) zum Einleiten einer Betätigungskraft zum Bewegen des mindestens einen Werkzeugelements (26, 28).
• 48. Chirurgisches Instrument nach Satz 47, gekennzeichnet durch ein Kraftübertragungsglied (14), welches einerseits mit dem mindestens einen verschwenkbaren Werkzeugelement (26, 28) und andererseits mit der Betätigungseinrichtung (22) beweglich gekoppelt ist, zum Übertragen einer Betätigungskraft von der Betätigungseinrichtung (22) auf das mindestens eine verschwenkbare Werkzeugelement (26, 28).
• 49. Chirurgisches Instrument nach Satz 48, dadurch gekennzeichnet, dass das Kraftübertragungsglied (14) am oder im Schaft (12) verschiebbar und/oder rotierbar gelagert ist.
• 50. Verfahren zum Herstellen eines chirurgischen Instruments mit mindestens einem auf einer Lagerwelle verschwenkbar gelagerten Werkzeugelement, welche Lagerwelle mit einer Befestigungseinrichtung am Instrument festgelegt wird, dadurch gekennzeichnet, dass die Befestigungseinrichtung ein Verbindungsglied, ein erstes Anlageelement und ein zweites Anlageelement umfasst, dass die Anlageelemente am Verbindungsglied gehalten und relativ zueinander von einer Anlegestellung, in welcher die Lagerwelle relativ zum Instrument axial bewegbar ist, in Richtung einer von ihr definierten Längsachse aufeinander zu verschoben werden in eine Befestigungsstellung, in welcher die Lagerwelle am Instrument axial unbeweglich gehalten ist.

The above description therefore includes in particular the embodiments of a surgical instrument explicitly listed below in the form of numbered sets and a method for producing a surgical instrument:

• 1. Surgical instrument ( 10 ) with at least one on a bearing shaft ( 46 ) pivotally mounted tool element ( 26 . 28 ), which bearing shaft ( 46 ) with a fastening device, ( 56 ) on the instrument ( 10 ) is determined by in that the fastening device ( 56 ) a link ( 58 ), a first investment element ( 60 ) and a second contact element ( 62 ), which investment elements ( 60 . 62 ) on the connecting link ( 58 ) and relative to each other from a landing position, in which the bearing shaft ( 46 ) relative to the instrument ( 10 ) is axially movable, in the direction of a longitudinal axis defined by it ( 38 ) are mutually displaceable in a fastening position in which the bearing shaft ( 46 ) on the instrument ( 10 ) is held axially immovable.
• 2. Surgical instrument according to sentence 1, characterized in that the instrument ( 10 ) a shaft ( 12 ) and that the at least one tool element ( 26 . 28 ) on the shaft ( 12 ) is pivotally mounted.
• 3. Surgical instrument according to sentence 1 or 2, characterized in that the bearing shaft ( 46 ) at a distal end ( 24 ) or in the area of a distal end ( 24 ) of the instrument ( 10 ) is arranged.
• 4. Surgical instrument according to one of the preceding sentences, characterized in that the connecting member ( 58 ) a link portion ( 68 ), which the bearing shaft ( 46 ).
• 5. Surgical instrument according to one of the preceding sentences, characterized in that the connecting member ( 58 ) and the bearing shaft ( 46 ) are integrally formed.
• 6. Surgical instrument according to one of the sentences 2 to 5, characterized in that the abutment elements ( 60 . 62 ) in the attachment position directly or indirectly on an outer side of the shaft ( 12 ) issue.
• 7. Surgical instrument according to one of the sentences 2 to 6, characterized in that the abutment elements ( 60 . 62 ) in the fastening position under prestress against an outer side of the shaft ( 12 ) are held.
• 8. A surgical instrument according to any one of sentences 2 to 7, characterized by a biasing device ( 114 ) for holding the abutment elements ( 60 . 62 ) in the fastening position under prestress against an outer side of the shaft ( 12 ).
• 9. A surgical instrument according to sentence 8, characterized in that the pretensioning device ( 114 ) at least one biasing element ( 116 ) for holding the abutment elements in the fastening position under pretension against an outer side of the shaft ( 12 ).
• 10. Surgical instrument according to sentence 9, characterized in that the first or the second contact element ( 60 . 62 ) the at least one biasing element ( 116 ) form.
• 11. Surgical instrument according to sentence 9 or 10, characterized in that the at least one biasing element ( 116 ) is formed at least partially resiliently.
• 12. Surgical instrument according to sentence 11, characterized in that the at least one biasing element ( 116 ) at least one elastic retaining portion ( 118 ).
• 13. Surgical instrument according to one of the sentences 2 to 12, characterized in that the first and / or the second contact element ( 60 . 62 ) a shank bearing surface ( 66 . 90 ), which correspond to an outside of the shaft ( 12 ) is shaped.
• 14. A surgical instrument according to sentence 13, characterized in that the Schaftanlagefläche ( 66 . 90 ) flat or substantially flat on the outside of the shaft ( 12 ) is present.
• 15. Surgical instrument according to sentence 13 or 14, characterized in that the shank bearing surface ( 66 . 90 ) in the direction of the shaft ( 12 ) is pointing concavely curved.
• 16. Surgical instrument according to one of the preceding sentences, characterized in that the first and / or the second contact element ( 60 . 62 ) relative to the link ( 58 ) are slidably mounted on this at least in the landing position.
• 17. Surgical instrument according to one of the preceding sentences, characterized in that the first abutment element ( 60 ) and the link ( 58 ) are firmly connected.
• 18. Surgical instrument according to one of the preceding sentences, characterized in that the first abutment element ( 60 ) and the link ( 58 ) are integrally formed.
• 19. Surgical instrument according to one of the preceding sentences, characterized in that the fastening device ( 56 ) a safety device ( 106 ) for preventing movement of the first and second abutment elements ( 60 . 62 ) away from each other.
• 20. Surgical instrument according to sentence 19, characterized in that the first and / or the second contact element ( 60 . 62 ) relative to the link ( 58 ) only in one direction to the other investment element ( 60 . 62 ) to and not contrary to the effect of the safety device ( 106 ) on the connecting link ( 58 ) is displaceable.
• 21. Surgical instrument according to sentence 19 or 20, characterized in that the securing device ( 106 ) at least one first securing element ( 104 ) and at least a second, with the at least one first fuse element ( 104 ) engageable securing element ( 102 ) that the link ( 58 ) the at least one first fuse element ( 104 ) and that the first and / or the second contact element ( 60 . 62 ) the at least one second securing element ( 102 ).
• 22. Surgical instrument according to sentence 21, characterized in that the at least one first and the at least one second securing element ( 104 . 102 ) in the form of interacting locking elements ( 108 . 110 ) are formed.
• 23. Surgical instrument according to sentence 21 or 22, characterized in that the at least one second securing element ( 102 ) in the direction or substantially in the direction of the longitudinal axis ( 38 ) is pointing out.
• 24. Surgical instrument according to one of the sentences 21 to 23, characterized in that the at least one second securing element ( 102 ) or at least one free end ( 100 ) thereof in a direction parallel or substantially parallel to one of the link ( 58 ) defined longitudinal axis ( 38 ) is spring-mounted.
• 25. Surgical instrument according to one of the sentences 21 to 24, characterized in that the first and / or the second contact element ( 60 . 62 ) in a direction parallel or substantially parallel to the longitudinal axis ( 38 ) at least one elastically resilient retaining element ( 98 ) comprising a second securing element ( 102 ) carries or forms.
• 26. Surgical instrument according to one of the preceding sentences, characterized in that the first and / or the second contact element ( 60 . 62 ) an opening ( 92 ) having the connecting member ( 58 ) penetrated in the attachment position.
• 27. Surgical instrument according to sentence 26, characterized in that at least two retaining elements ( 98 ) provided by the opening ( 92 ) outgoing incision ( 94 ) separates from each other.
• 28. Surgical instrument according to sentence 27, characterized in that the incision ( 94 ) in the radial direction of the opening ( 92 ) extends away.
• 29. Surgical instrument according to sentence 27 or 28, characterized in that the incision ( 94 ) extends at least in sections in the circumferential direction.
• 30. Surgical instrument according to one of the sentences 27 to 29, characterized in that the incision ( 94 ) is formed one or more curved.
• 31. Surgical instrument according to one of the sentences 21 to 30, characterized in that a plurality of first, in the form of teeth ( 74 ) formed security elements ( 104 ) are provided and that these teeth have a safety toothing ( 84 ) train.
• 32. Surgical instrument according to sentence 31, characterized in that each tooth ( 74 ) a retaining surface ( 76 ) and a sliding surface ( 78 ), that the retaining surface ( 76 ) substantially in the direction of the contact element ( 60 ), which does not interfere with the safety toothing ( 84 ) is engaged, and that the sliding surface ( 78 ) points essentially in the opposite direction.
• 33. Surgical instrument according to sentence 31 or 32, characterized in that the teeth ( 74 ) on an outer side of the connecting link ( 58 ) at least one parallel to the longitudinal axis ( 38 ) extending row of teeth ( 80 . 82 ) define.
• 34. Surgical instrument according to sentence 33, characterized by two or more rows of teeth ( 80 . 82 ).
• 35. Surgical instrument according to sentence 33 or 34, characterized in that the teeth ( 74 ) of each row of teeth ( 80 . 82 ) are arranged equidistantly.
• 36. Surgical instrument according to one of the sentences 31 to 35, characterized in that the teeth ( 74 ) of circumferentially adjacent rows of teeth ( 80 . 82 ) are arranged axially offset from each other.
• 37. Surgical instrument according to one of the preceding sentences, characterized in that the connecting member ( 58 ) mirror-symmetrical to at least one of the longitudinal axis ( 38 ) formed mirror plane is formed.
• 38. Surgical instrument according to one of the preceding sentences, characterized in that the first and / or the second contact element ( 60 . 62 ) are circular, substantially circular, oval, substantially oval, polygonal or substantially polygonal.
• 39. Surgical instrument according to one of the preceding sentences, characterized in that the first and / or the second contact element ( 60 . 62 ) Compensation elements ( 120 ) which are elastically displaced in a direction parallel or substantially parallel to the longitudinal axis ( 38 ) are deformable.
• 40. Surgical instrument according to sentence 39, characterized in that the compensating elements ( 120 ) in the form of compensating spring elements ( 122 ) are formed.
• 41. Surgical instrument according to sentence 40, characterized in that adjacent compensating spring elements ( 122 ) through a slot ( 124 ) are separated from each other, which starting from a the respective investment element ( 60 ) limiting edge in the radial direction or substantially in the radial direction on the longitudinal axis ( 38 ) extends.
• 42. Surgical instrument according to one of the sentences 39 to 41, characterized in that the first and / or the second contact element ( 60 . 62 ) is formed from a wave-shaped profiled body and that the wave-shaped profile, the compensating spring elements ( 122 ) at least partially defines or forms.
• 43. Surgical instrument according to one of the preceding sentences, characterized in that the bearing shaft ( 46 ) is formed in the form of a cylindrical rod.
• 44. Surgical instrument according to one of the preceding sentences, characterized in that the bearing shaft ( 46 ) no security elements ( 104 ) wearing.
• 45. Surgical instrument according to one of the sentences 21 to 44, characterized in that an outer diameter of the connecting member ( 58 ) in the area of the bearing shaft ( 46 ) equal to or greater than an outer diameter in the region of the first securing elements ( 104 ).
• 46. Surgical instrument according to one of the sentences 2 to 45, characterized in that the bearing shaft ( 46 ) a bearing shaft longitudinal axis ( 38 ) defines that the shaft ( 12 ) a shaft axis ( 16 ) and that the bearing shaft longitudinal axis ( 38 ) transversely, in particular perpendicular, to the shaft axis ( 16 ) runs.
• 47. Surgical instrument according to one of the preceding sentences, characterized by a at the proximal end of the instrument ( 10 ), trained or connectable with this actuator ( 22 ) for introducing an actuating force for moving the at least one tool element ( 26 . 28 ).
• 48. Surgical instrument according to sentence 47, characterized by a force transmission member ( 14 ), which on the one hand with the at least one pivotable tool element ( 26 . 28 ) and on the other hand with the actuating device ( 22 ) is movably coupled, for transmitting an actuating force from the actuating device ( 22 ) on the at least one pivotable tool element ( 26 . 28 ).
• 49. Surgical instrument according to sentence 48, characterized in that the force transmission member ( 14 ) on or in the shaft ( 12 ) is slidably and / or rotatably mounted.
• 50. A method for producing a surgical instrument having at least one pivotably mounted on a bearing shaft tool element, which bearing shaft is fixed with a fastening device on the instrument, characterized in that the fastening device comprises a connecting member, a first contact element and a second contact element, that the contact elements on Held connecting member and relative to each other from a landing position in which the bearing shaft is axially movable relative to the instrument to be displaced towards each other in the direction of a longitudinal axis defined by it in a mounting position in which the bearing shaft is held immovable axially on the instrument.

The following description of preferred embodiments of the invention is used in conjunction with the drawings for further explanation. Show it:

1 a schematic, perspective overall view of a surgical instrument;

2 a partially broken, enlarged view of area A in FIG 1 ;

3 : A perspective, schematic representation of the instrument 1 in the field of storage of its tool elements;

4 : an enlarged schematic representation of the in the 1 to 3 illustrated fastening device;

5 : a view similar 4 a further embodiment of a fastening device; and

6 : a view similar 4 a further embodiment of a fastening device.

In 1 is schematically a surgical instrument 10 represented in the form of an endoscopic tubular shaft instrument. It includes an elongated, tubular shaft 12 in which a power transmission member 14 parallel to one of the shaft 12 defined shaft axis 16 is slidably mounted. The force transmission member is on the one hand movably coupled to a pivotably mounted on a proximal end of the shaft actuator 18 another, immovable actuator 20 comprehensive actuator 22 and on the other hand with two on the shaft 12 at its distal end 24 or in the region of its distal end 24 pivotally mounted tool elements 26 and 28 , These are exemplified co-operating cutting elements for forming an endoscopic scissors. Of course, other types of tool elements are conceivable, for example, tool elements in the form of jaws or other holding elements for forming surgical instruments in the form of clamps or forceps.

The assembly and storage of the tool elements 26 and 28 on the shaft 12 will be explained in more detail below.

At the distal end 24 has the shaft 12 an incision extending in the direction of the shaft axis 30 on which two bearing arms 32 and 33 defined, their inner surfaces 34 and 36 parallel to each other and to the shaft axis 16 run. The bearing arms 32 are one of a longitudinal axis 38 defining transverse bore 40 slightly proximal to the free ends 42 and 44 the bearing arms 32 interspersed. The transverse bore 40 serves to accommodate a bearing shaft 46 , The bearing shaft 46 is rod-shaped and has a cylindrical shape with a macroscopic smooth outer surface. An outer diameter of the bearing shaft 46 is to an inner diameter of the tool elements 26 and 28 passing through bearing bore 48 customized. Between the bearing bore 48 and the bearing shaft 46 is provided for surgical instruments usual game, which is only so large that there is a sufficiently defined pivoting of the tool elements 26 and 28 around the longitudinal axis 38 allows.

Proximal ends 50 the tool elements 26 and 28 stand with a coupling piece 52 engaging a distal end of the power transmission member 14 defines or forms. The coupling piece 52 has protruding coupling elements of the tool elements 26 and 28 cooperating guide slots 54 on which a movement of the power transmission member 14 parallel to the shaft axis in a pivoting movement of the tool elements 26 and 28 around the longitudinal axis 38 transform.

The definition of the bearing shaft 46 takes place by means of a fastening device 56 , This includes a link 58 and a first and a second contact element 60 . 62 , The first investment element 60 is in the form of a substantially rectangular, slightly curved plate 64 formed, which is a hollow cylindrical, to an outer diameter of the shaft 12 in the area of the bearing arm 33 having adapted curvature, so that a Schaftanlagefläche 66 of the slide 64 flat on the outside of the bearing arm 33 can be brought into contact.

The first investment element 60 is optionally fixed to the link 58 connected or integrally formed with this. It forms a first end of the connecting link 58 or is arranged or formed on this and extends substantially transversely to the longitudinal axis 38 , A first link portion 68 which directly adjoins the first contact element 60 connects, defines or forms the bearing shaft 46 , To the first link portion 68 closes a second link section 70 which is up to a first contact element 60 opposite end 72 of the connecting link 58 extends.

The second link portion 70 is with a variety of teeth 74 Mistake. Every tooth 74 has a retention surface 76 as well as a sliding surface 78 on. The retention area 76 points essentially in the direction of the first contact element 60 out. The sliding surface 78 points essentially in the opposite direction, ie essentially in the direction of the end 72 out. Distributed over the circumference are at the second link section two rows of teeth 80 as well as two tooth areas 82 educated. teeth 74 a row of teeth 80 respectively 82 each extend in a direction parallel to the longitudinal axis 38 , The teeth 74 every row of teeth 80 respectively 82 are arranged equidistantly to each other. Every row of teeth 80 respectively 82 is part of a total with the reference numeral 84 designated securing toothing.

The teeth 74 the circumferentially adjacent rows of teeth 80 and 82 are arranged offset from each other axially. This means that the teeth 74 axially in a position in their respective row of teeth 80 respectively 82 are arranged between the teeth 74 the adjacent row of teeth 82 respectively 80 lies. Thus, the distance between successive teeth 74 from adjacent rows of teeth 80 and 82 only half the distance between two teeth of the same row of teeth 80 respectively 82 , The structure of the second connecting link section can also be described as comprising a cross-sectionally square, rod-shaped base body, each of which is of the longitudinal axis 38 away facing side surfaces one row of teeth 80 respectively 82 wear. This is especially true at the square end face 86 the second link portion 70 distinct, such as in 4 clearly visible.

The second investment element 62 is in the form of a substantially square plate 88 formed, which also has a concave Schaftanlagefläche 90 which is connected to an outer diameter of the shaft 12 is adapted to be as extensive as possible to be brought into this plant.

The second investment element 62 has a centrally located opening 92 on, which is for receiving the second link portion 70 is provided. Starting from the opening 92 four are in the radial direction of the opening 92 away extending incisions 94 intended. They are not quite up to the long sides of the slide 88 , Between adjacent incisions 94 become retaining elements 98 Are defined. Because of their shape as well as the strength of the platelet 88 forming material, they are essentially elastically resilient.

Towards the longitudinal axis 38 pointing free ends 100 the retaining elements form second securing elements 102 that with first security elements 104 interact and a total with the reference numeral 106 form designated safety device. The first fuse elements 104 be in the in the 1 to 4 illustrated embodiment of a fastening device through the teeth 74 or between two adjacent teeth 74 defined recesses defined. The safety device 106 serves to prevent movement of the first and the second contact element 60 . 62 relative to each other, and away from each other. Specifically, it prevents the second attachment element 62 in a direction away from the first abutment member relative to the link 58 can be moved. The special design of the teeth 74 and the security device 106 Make sure the second investment element 62 only in the direction of the first contact element 60 and thus not contrary to the effect of the safety device 106 on the link 58 is displaceable. This is achieved in particular by the fact that the first and second securing elements 104 . 102 in the form of interacting locking elements 108 and 110 are formed.

The free ends of the second securing elements 102 are due to the design of the retaining elements 98 in a direction parallel or substantially parallel to the longitudinal axis 38 spring-mounted. They make it possible after insertion of the end 72 of the connecting link 58 in that the locking elements 110 at the sliding surfaces 78 the teeth 74 slip on and then between two adjacent teeth 74 latch, taking with their from the first investment element 60 away-facing surfaces 112 with the retention surfaces 76 contact. These are designed so that a return displacement of the second contact element 62 from the first investment element 60 away is not possible. In particular, they are conveniently perpendicular to the longitudinal axis 38 or slightly inclined forward, leaving an undercut in the direction of the first abutment element 60 is formed.

Overall, the fastening device 56 thus formed such that the contact elements 60 . 62 relative to each other from a landing position, in which the bearing shaft 46 relative to the shaft 12 of the instrument 10 is axially movable, in the direction of the longitudinal axis 38 can be displaced towards each other in a mounting position, in which the bearing shaft 46 on the shaft 12 of the instrument 10 held axially immovable, ie in particular no longer in the direction of the longitudinal axis 38 can be moved. Due to the special design of the investment elements 60 . 62 , in particular due to their concave shaped Schaftanlageflächen 66 . 90 , In the mounting position, a rotation of the bearing shaft 46 around the longitudinal axis 38 essentially prevented. However, this is for the function of the instrument 10 not mandatory.

The investment elements 60 . 62 lie in the attachment position directly to an outside of the shaft 12 if this shaft 12 not provided with a protective layer or sheath. In this case, the contact elements would be 60 . 62 indirectly on the outside of the shaft 12 at.

The investment elements 60 . 62 are also in the mounting position under bias against the outside of the shaft 12 held. This causes a total with the reference numeral 114 designated biasing means for holding the abutment elements 60 . 62 in the mounting position under bias against the outside of the shaft 12 , The pretensioner 114 includes in the present embodiment at least one biasing element 116 namely, the abutment element 62 , As already described above, the biasing element 116 at least partially resilient. So it comprises a total of four elastic restraint sections 118 passing through the retaining elements 98 be formed. Will be the second investment element 62 in the direction of the first contact element 60 pushed forward, so support the restraint sections 118 at the retention areas 76 off and hold the shank contact surface 90 of the second contact element 62 against the outside of the shaft 12 under tension.

In variants, not shown, in particular second contact elements 62 can the cuts 94 at least partially in the circumferential direction relative to the longitudinal axis 38 extend. Furthermore, they can also be formed one or more times curved.

As in the 1 to 4 good to see, carries the bearing shaft 46 even no fuse elements 104 , In addition, an outer diameter of the connecting member 58 in the area of the bearing shaft 46 not smaller than the outer diameter in the area of the first securing elements 104 ,

In 5 is another embodiment of a fastening device 56 shown schematically. It is different from the one in the 1 to 4 shown and described above fastening device 56 especially in that the incisions 94 on the second contact element 62 starting from the opening 92 towards the corners of the tile 88 clues.

Another difference is the design of the first contact element 60 firmly connected or optionally integral with the link 58 is trained. The first investment element 60 is designed in the form of a curved small disk. Starting from a peripheral edge of the contact element 60 are several slots 124 in the radial direction on the longitudinal axis 38 directed directed towards the between them compensating spring elements 122 Define, due to the elastic material, from which the first investment element 60 is preferably made, elastically in a direction parallel or substantially parallel to the longitudinal axis 38 are deformable. They serve to manufacturing tolerances and due to the predetermined distances of the teeth 74 the tooth-rich 80 and 82 compensate for predetermined tolerances resulting tolerances when the bearing shaft 46 on the shaft 12 is determined. The first investment element 60 is in the direction of the second contact element 62 pointing concavely curved and can due to the elastic properties of the compensating spring elements 122 also substantially flat on the outside of the shaft 12 issue.

Another embodiment of a fastening device 56 is in 6 shown schematically. The connecting link 58 corresponds in its structure to the link 58 in the 1 to 5 illustrated and described above embodiments of fasteners 56 ,

The first investment element 60 corresponds in its basic form to the contact element 60 of in 5 illustrated embodiment, but this has no slots 124 on. However, this is the first investment element 60 Overall slightly resilient, which is made possible by the wavy profiled shape.

The second investment element 62 corresponds in its function to the second contact elements 62 in the 4 and 5 illustrated embodiments. The second investment element 62 at the in 6 illustrated embodiment, however, is in the form of a slightly curved disc, which, starting from the central opening 92 a total of six equally distributed in the circumferential direction, each extending in the radial direction incisions, the thus between a total of six second securing element 102 define. Their function corresponds to the function of the fuse elements 102 the one above in connection with 4 described fastening device 56 ,

The configuration of the first and second link sections 68 and 70 is at all in the 4 to 6 illustrated embodiments identical. Related to the above description 4 will be referred.

All fastening devices described above 56 may optionally be wholly or partly formed of a biocompatible metal or a biocompatible plastic. The materials mentioned may vary depending on whether it is the instrument 10 is a disposable or reusable instrument, also steam sterilizable or not.

When mounting the instrument is used to set the tool elements 26 . 28 on the shaft 12 in each case with the first contact element 60 connected link 58 after positioning the tool elements 26 . 28 in the incision 30 and subsequent alignment of the bearing bores 48 for transverse drilling 40 with the end 72 ahead through the cross hole 40 of the bearing arm 33 , the bearing holes 48 the two tool elements 26 . 28 as well as the transverse bore 40 on the bearing arm 32 pushed, until the shaft contact surface 66 on the shaft 12 is applied. Subsequently, the second contact element 62 to the end 72 introduced and this through the opening 92 therethrough. In this case or thereafter, the first investment element 60 held in position and the second contact element 62 in the direction of the first contact element 60 advanced so far, this also on the shaft 12 is applied. The bearing shaft 46 is now positioned and captive on the shaft 12 secured. The part of the second link portion 70 from the shaft axis 16 pointing away over the second contact element 62 protruding, is then separated, for example by means of pliers, to minimize the risk of injury. The tool elements 26 and 28 are now in the desired manner on the shaft 12 stored.

Claims (25)

Surgical instrument ( 10 ) with at least one on a bearing shaft ( 46 ) pivotally mounted tool element ( 26 . 28 ), which bearing shaft ( 46 ) with a fastening device ( 56 ) on the instrument ( 10 ), characterized in that the fastening device ( 56 ) a link ( 58 ), a first investment element ( 60 ) and a second contact element ( 62 ), which investment elements ( 60 . 62 ) on the connecting link ( 58 ) and relative to each other from a landing position, in which the bearing shaft ( 46 ) relative to the instrument ( 10 ) is axially movable, in the direction of a longitudinal axis defined by it ( 38 ) are mutually displaceable in a fastening position in which the bearing shaft ( 46 ) on the instrument ( 10 ) is held axially immovable. Surgical instrument according to claim 1, characterized in that the instrument ( 10 ) a shaft ( 12 ) and that the at least one tool element ( 26 . 28 ) on the shaft ( 12 ) is pivotally mounted. Surgical instrument according to one of the preceding claims, characterized in that the connecting member ( 58 ) one Connecting link section ( 68 ), which the bearing shaft ( 46 ). Surgical instrument according to one of the preceding claims, characterized in that the connecting member ( 58 ) and the bearing shaft ( 46 ) are integrally formed. Surgical instrument according to one of claims 2 to 4, characterized in that the abutment elements ( 60 . 62 ) in the fastening position under prestress against an outer side of the shaft ( 12 ) are held. Surgical instrument according to one of Claims 2 to 5, characterized by a pretensioning device ( 114 ) for holding the abutment elements ( 60 . 62 ) in the fastening position under prestress against an outer side of the shaft ( 12 ) that the pretensioning device ( 114 ) at least one biasing element ( 116 ) for holding the abutment elements in the fastening position under pretension against an outer side of the shaft ( 12 ). Surgical instrument according to claim 6, characterized in that the first or the second contact element ( 60 . 62 ) the at least one biasing element ( 116 ) and / or that the at least one biasing element ( 116 ) is formed at least partially resiliently. Surgical instrument according to claim 6 or 7, characterized in that the at least one biasing element ( 116 ) at least one elastic retaining portion ( 118 ). Surgical instrument according to one of claims 2 to 8, characterized in that the first and / or the second contact element ( 60 . 62 ) a shank bearing surface ( 66 . 90 ), which correspond to an outside of the shaft ( 12 ) and which preferably flat or substantially flat on the outside of the shaft ( 12 ) is present. Surgical instrument according to one of the preceding claims, characterized in that the first and / or the second contact element ( 60 . 62 ) relative to the link ( 58 ) are slidably mounted on this at least in the landing position. Surgical instrument according to one of the preceding claims, characterized in that the first abutment element ( 60 ) and the link ( 58 ) are firmly connected or integrally formed. Surgical instrument according to one of the preceding claims, characterized in that the fastening device ( 56 ) a safety device ( 106 ) for preventing movement of the first and second abutment elements ( 60 . 62 ) away from each other. Surgical instrument according to claim 12, characterized in that the securing device ( 106 ) at least one first securing element ( 104 ) and at least a second, with the at least one first fuse element ( 104 ) engageable securing element ( 102 ) that the link ( 58 ) the at least one first fuse element ( 104 ) and that the first and / or the second contact element ( 60 . 62 ) the at least one second securing element ( 102 ), and that preferably the at least one first and the at least one second securing element ( 104 . 102 ) in the form of interacting locking elements ( 108 . 110 ) are formed. Surgical instrument according to one of the preceding claims, characterized in that the first and / or the second contact element ( 60 . 62 ) an opening ( 92 ) having the connecting member ( 58 ) penetrated in the attachment position. Surgical instrument according to claim 14, characterized in that at least two retaining elements ( 98 ) provided by the opening ( 92 ) outgoing incision ( 94 ) separates from each other. Surgical instrument according to one of claims 13 to 15, characterized in that a plurality of first, in the form of teeth ( 74 ) formed security elements ( 104 ) are provided and that these teeth have a safety toothing ( 84 ) train. Surgical instrument according to claim 16, characterized in that the teeth ( 74 ) on an outer side of the connecting link ( 58 ) at least one parallel to the longitudinal axis ( 38 ) extending row of teeth ( 80 . 82 ), preferably two or more rows of teeth ( 80 . 82 ). Surgical instrument according to claim 16 or 17, characterized in that the teeth ( 74 ) of circumferentially adjacent rows of teeth ( 80 . 82 ) are arranged axially offset from each other. Surgical instrument according to one of the preceding claims, characterized in that the first and / or the second contact element ( 60 . 62 ) Compensation elements ( 120 ) which elastically in a direction parallel or substantially parallel to the longitudinal axis ( 38 ) are deformable. Surgical instrument according to claim 19, characterized in that the compensating elements ( 120 ) in the form of compensating spring elements ( 122 ) are formed and that preferably adjacent compensating spring elements ( 122 ) through a slot ( 124 ) are separated from each other, which starting from a the respective investment element ( 60 ) limiting edge in the radial direction or substantially in the radial direction on the longitudinal axis ( 38 ) extends. Surgical instrument according to claim 19 or 20, characterized in that the first and / or the second contact element ( 60 . 62 ) is formed from a wave-shaped profiled body and that the wave-shaped profile, the compensating spring elements ( 122 ) at least partially defines or forms. Surgical instrument according to one of the preceding claims, characterized in that the bearing shaft ( 46 ) no security elements ( 104 ) wearing. Surgical instrument according to one of claims 13 to 22, characterized in that an outer diameter of the connecting member ( 58 ) in the area of the bearing shaft ( 46 ) equal to or greater than an outer diameter in the region of the first securing elements ( 104 ). Surgical instrument according to one of the preceding claims, characterized by a at the proximal end of the instrument ( 10 ), trained or connectable with this actuator ( 22 ) for introducing an actuating force for moving the at least one tool element ( 26 . 28 ). Method for producing a surgical instrument having at least one tool element mounted pivotably on a bearing shaft, which bearing shaft is fastened to the instrument by a fastening device, characterized in that the fastening device comprises a connecting element, a first contact element and a second contact element, which holds the contact elements on the connecting element and relative to each other from a landing position, in which the bearing shaft is axially movable relative to the instrument, are displaced towards each other in the direction of a longitudinal axis defined by it in a mounting position in which the bearing shaft is held axially immovable on the instrument.

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