DE20305915U1 - Rasping accessory for surgical instrument has motor-driven hand-piece with fastening, and curved rasping part, - Google Patents

Abstract

The rasping accessory (40) is fixed to the motor-driven surgical hand-piece (70) by means of a fastening (44) at one end (42) of the rasping accessory the other end (46) of which carries a rasping part. The rasping accessory, which has a concave or convex surface in the elastically deformable rasping part (50), moves to and fro and thereby grates material from the surface.

Description

SCHOPPEL,

Patent attorneys ■ PO Box 246 ■ 82043 Pullach near Munich

Dr. med. Martin Nolde Grosse Allee 42 89407 Dillingen

PATENT ATTORNEYS

European Patent Attorneys European Trademark Attorneys

Fritz Schoppe, Dipl.-Ing.
Tankred Zimmermann, Dipl.-Ing. Ferdinand Stöckeier, Dipl.-Ing.
Franz Zinkler, Dipl.-Ing.

Telephone/Telephone 089/790445-0 Fax/Facsimile 089/790 22 1 5 Fax/Facsimile 089/74996977

e-mail: szsz_iplaw@t-online.de

RASP ATTACHMENT FOR A MOTOR-DRIVEN SURGICAL HAND DEVICE

Postal address: P.O. Box 246, 82043 Pullach near Munich

Office address: Hermanrv-Roth _# -Wqg 1, SgO^Pullach.beiJVIünchen

Bank details/Bank|Ps:.^YpbVei4rr|spaijk ^rünjv^ctiionttiniirrTiJneJ-.a 960-15?5 0*^8 (bank code 700 202 70)

Postgjroijirrt MünclrterC K&rsto£iurSnrrter,3i5 7%$-8$ß (ßLE 7ohT>O2Q)

'" USf-Fd NrV^T^eg'stration Number*DE 130575439

Rasp attachment for a motor-driven surgical handpiece

Description

The present invention relates to a rasp attachment for a motor-driven surgical hand-held device for removing bone or other solid tissue.

In numerous surgical procedures, bone substance is removed by filing, rasping, planing or milling in order to model bone surfaces. This is necessary, for example, to eliminate a bottleneck, to prepare for the insertion of an implant or to rework surface structures that have arisen during a previous, rougher processing step. An example from shoulder surgery is described below.

In the human shoulder, an anatomical variant of the acromion very often leads to a bony bottleneck, which is known as impingement syndrome. This bottleneck usually leads to chronic movement- and load-related pain in the shoulder area in middle age. The chronic mechanical irritation often leads to progressive damage to a tendon cuff located under the acromion, the rotator cuff. To treat impingement syndrome, the widening of the sliding space under the acromion has become established worldwide. Fig. 5 and 6 show schematic representations of the acromion in longitudinal section and sagittal section in two different treatment stages.

Fig. 5 shows the acromion or shoulder roof 10, the humeral head 12 and the rotator cuff 14 in between in their original state. The outer edge 16 of the shoulder

roof 10 is pulled down too far, so that the movement of the shoulder joint or the humeral head 12 in the roof 10 is restricted. The surgical procedure outlined below is called acromioplasty.

In classic acromioplasty, the acromion is modified using a chisel, as specified by the first author (Neer). In recent years, an oscillating saw has been used predominantly to work on the acromion 10. Two saw cuts 22, 24 are made using the oscillating saw to remove the protruding edge 16 of the acromion 10. However, only straight or flat saw cuts can be made using the saw. This creates an edge 28 on the underside 26 of the acromion 10 facing the rotator cuff 14 or the humeral head 12, on which a burr usually remains. This burr is then removed using a hand rasp or a ball milling cutter. However, this procedure is laborious and does not protect the tissue very well.

Depending on the extent to which the shape of the acromion 10 deviates from the ideal norm, the lower surface or underside 26 of the acromion 10 is thinned out during acromioplasty in order to expand the sliding space of the shoulder joint. The condition of the acromion 10 after acromioplasty is shown in Fig. 6. Broken lines indicate the contour of the acromion 10 before the procedure and before thinning. The edge 16 of the acromion 10 was removed by saw cuts 22, 24, and a layer 30 was removed from the underside 26 of the acromion 10 in order to form a new underside ^26f of the acromion 10.

The state shown in Fig. 6 represents an ideal state. As a rule, however, a concave shape of the lower surface 26 of the shoulder roof 10 cannot be achieved with the hand rasp. Another disadvantage of the stand

The disadvantage of the technique, as already indicated, is that the use of a hand rasp or a ball milling cutter to work on the acromion 10 is laborious and not very tissue-protecting.
5

The object of the present invention is to provide an improved material-removing tool for surgical applications.

This object is achieved by a rasp attachment according to claim 1.

The present invention provides a rasp attachment for a motor-driven surgical hand-held device with a fastening device for fastening the rasp attachment to the motor-driven surgical hand-held device and a rasp region which is designed to remove material from a surface during a reciprocating movement of the rasp attachment caused by the motor-driven surgical hand-held device.

The present invention is based on the knowledge that a surgeon can remove or model solid tissue, such as bone, much more easily if he can concentrate exclusively on the arrangement and alignment of the rasp relative to the tissue to be modeled, on the contact pressure and on feeling the interaction between the rasp and the tissue, and does not have to use force and energy and ensure that his manual rasp movements are consistent. In this context, the present invention has the advantage that the surgeon can remove material more effortlessly, much more sensitively, evenly and with more sensitivity than with a conventional hand rasp.

According to the present invention, the actual rasping work is performed by the motor-driven surgical hand tool.

device whose intrinsic property is that it carries out the material-removing back and forth movement of the rasp or file attachment in a kinematic and dynamically almost completely uniform manner. The surgeon can concentrate on determining the exact location of the material removal by arranging and aligning the rasp attachment relative to the tissue to be modelled, setting the removal rate by the pressure of the rasp attachment or its rasp area on the surface to be removed, observing the interaction of the rasp attachment with the surface to be removed and, if necessary, moving the location of the material removal as continuously as possible by means of a slow and uniform pivoting or translational movement of the handpiece in order to prevent steps from forming, for example. Observing the interaction of the rasp attachment with the surface to be worked on primarily involves observing the frictional force between the rasp area and the surface to be removed. It also includes observation of the reaction on the motor-driven handpiece, which influences, for example, the frequency of the back and forth movement or a noticeable shaking of the handpiece. In addition, the surgeon can feel steps and edges on the surface to be removed via the rasp attachment and the handpiece. All of this enables work to be carried out more effortlessly, with less fatigue and therefore more concentrated, more precise, gentler on the tissue, faster and therefore more time-saving.

Preferably, the rasp attachment is curved in one or two directions at least in the rasp area, whereby the rasp area can be either convex or concave. A curved rasp area has the advantage that curved surfaces can be easily modelled and that the risk of steps forming on a surface to be removed is reduced and continuous or rounded transitions are created almost automatically.

Furthermore, the rasp attachment is preferably elastic, at least in the rasp area, which allows for individual adjustment of the resecting measure. In particular, the elasticity of the rasp attachment allows its shape to be adjusted to the surface to be treated simply by the force exerted on the rasp attachment via the handpiece in the direction of the surface to be treated. The elasticity of the rasp attachment therefore also contributes to the formation of step-free, rounded surfaces with transitions that are as continuous as possible and reliably prevents the formation of burrs, for example.

Particularly preferably, the rasp attachment has a higher elasticity at its tip or in an area remote from the handpiece than in an area close to the handpiece. This further improves the adaptation of the shape of the rasp attachment to the surface to be treated. Optimal adaptation or optimal adaptability of the rasp attachment to the surface to be treated is achieved if the elasticity of the rasp attachment is continuously increasing from the fastening device to its end remote from the fastening device.

Preferably, the rasp attachment is further perforated at least in the rasp area to allow rinsing fluid to pass through. Uniform rinsing of the rasp area and the surface being worked on is important to remove removed material and so that the rasp does not become clogged but rather its material-removing effect is maintained. Furthermore, rinsing is important to cool or temper the surface being worked on and the surrounding tissue to avoid excessive heating, which would result in tissue damage. Preferably, the rasp attachment is elongated, with the fastening device at one end and the rasp area at the other end of the rasp attachment.

are arranged. Furthermore, the rasp attachment is preferably : ,··, ;··· .··. .: :*·* &iacgr;&iacgr;·&iacgr;

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designed in such a way that it is pivoted back and forth by the motor-driven surgical handpiece about an axis close to the fastening device, so that the rasp area performs an oscillating movement along an arc segment. This enables uniform and, depending on the amplitude of the oscillation, surface or local removal of material. A rasp area in the sense of the present invention is also a fine rasp area or filing area. Furthermore, the term "rasp area" according to the present invention includes not only a filing area but also a planing area with one or more edges or cutting edges that are arranged perpendicular to the direction of movement of the rasp area.

Preferred further developments are defined in the subclaims.

Preferred embodiments of the present invention are explained in more detail below with reference to the accompanying drawings.

Fig. IA schematic views of a rasp attachment to IC according to a preferred embodiment of the

present invention from three directions; 25

Fig. 2 is a schematic representation of a rasp attachment according to the present invention with a motor-driven surgical handpiece;

Fig. 3 schematic representations of an operating area and 4 with a rasp attachment according to the present invention; and

Fig. 5 Schematic representations of a surgical area and 6 before and after acromioplasty.

Fig. IA, IB, IC show a rasp attachment 40 according to a preferred embodiment of the present

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Invention from three different perspectives. The rasp attachment 40 has approximately the shape of a slightly curved, elongated plate or sheet metal strip. Fig. 1A shows the rasp attachment 40 in a side view or from a direction perpendicular to the direction in which the rasp attachment 40 has its greatest extent and approximately parallel to the direction in which the rasp attachment 40 has its second greatest extent. Fig. IB shows the rasp attachment 40 in a view from above or from the side on which the rasp area is arranged or from a direction in which the rasp attachment has its smallest extent. Fig. IC shows a representation of a section through the rasp attachment 40 along the line C-C in Fig. IB.

It can be seen that the rasp attachment 40 has approximately the shape of an elongated, rectangular sheet metal strip, at one end 42 of which a fastening device 44 is arranged for fastening the rasp attachment 40 to a motor-driven surgical handpiece. The other end 46 of the rasp attachment 40 is rounded. Near the rounded end 46 there is a rasp region 50 in which one or more, preferably a plurality of small cones, pyramids, ridges or other convex elements 52 protrude from the surface of the rasp attachment 40. Each convex element 52 has one or more (preferably sharp) edges which are designed to remove material from a surface along which the rasp region 50 is moved. The rasp region 50 is similar to the rasp region of a conventional hand rasp or hand file.

In Fig. 1A it can be seen that the rasp attachment 40 has a longitudinal curvature, particularly in the area of the rasp area 50. In Fig. 1C it can be seen that the rasp attachment 40 also has a curvature in the transverse direction, at least in the area of the rasp area 50. The rasp area 50

is arranged in this embodiment on the convex side of the curvature of the rasp attachment 40.

The rasp attachment 40 is designed to be operated preferably on a motor-driven surgical hand-held device that pivots the rasp attachment 40 back and forth about an axis that is arranged close to the fastening device 44. The arrow 60 in Fig. 1B indicates this oscillating pivoting movement.

Fig. 2 is a schematic side view of the rasp attachment 40 shown in Figs. IA, IB together with a motor-driven surgical handpiece 70 to which the rasp attachment 40 is attached. The motor-driven surgical handpiece 70 has an elongated, ergonomically optimized shape that enables secure, force-fitting and fatigue-free holding with one or two hands. At a front end 72, the motor-driven surgical handpiece 70 has a receptacle 74 for receiving the fastening device 44 of the rasp attachment 40, which enables a force-fitting connection to the fastening device 44. A securing element 76, for example a knurled screw, is provided and designed to reliably hold the fastening device 44 of the rasp attachment 40 to the receptacle 74.

The handpiece 70 is supplied with compressed air or another pressurized fluid or with electrical power via one or more hoses or a cable 78. A pneumatic or hydraulic or electrical motor driven inside the motor-driven surgical handpiece 70 rotates the holder 74 back and forth. As a result, the rasp area 50 of the rasp attachment 40 is moved back and forth in a circular arc as shown in Fig. 1B by the arrow 60. In other words, the rasp area 50 is moved back and forth perpendicular to the longitudinal extension of the rasp attachment 40.

Alternatively, the handpiece 70 is designed such that it causes a radial back and forth movement of the rasp attachment simultaneously with or switchably instead of the back and forth movement perpendicular to the longitudinal extension of the rasp attachment 40. A radial movement is a movement parallel to the longitudinal extension of the rasp attachment 40. Both movements, if they are carried out simultaneously, have the same or different amplitudes and frequencies.

Both the motor-driven surgical handpiece 70 and the rasp attachment 40 are preferably sterilizable. Alternatively, the rasp attachment 40 is intended for single use after which it is discarded or disposed of.

3 and 4 show schematic sectional views of an operation area and the use of the rasp attachment according to the invention. The acromioplasty for treating impingement syndrome described above is again shown as an example. In Fig. 3, the acromion 10 is shown in the state after the two flat saw cuts described above with reference to Figs. 5 and 6 have been made. First, a flexible metal spatula (Düsseldorf spatula), as used in abdominal surgery, is placed between the rotator cuff 14 and the acromion 10 to protect it. This spatula can simultaneously press the joint head or humeral head 12 with the rotator cuff 14 downwards or move it away from the acromion 10. This creates additional working space between the rotator cuff 14 and the acromion 10. After placing the spatula 80, the rasp attachment 40 is inserted between the spatula 80 and the acromion 10.

The state thus achieved is shown in Fig. 4. Now, by the oscillating movement of the rasp area 50 of the rasp attachment 40 along the underside.2§ of the school

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terdaches 10, this is removed in order to achieve the state already shown at the beginning with reference to Fig. 6. By using the oscillating rasp attachment 40 with the curved rasp area 50, the lower surface 26 of the shoulder roof 10 is thinned, formed concavely and the cutting surface of the previous saw cut is smoothed or the burr 28 is removed in a single work step.

In addition to the acromioplasty described above, the rasp attachment according to the invention can also be used in other orthopedic and traumatological procedures in which bone or other solid tissue is removed or modeled. Another example of an application of the rasp attachment according to the invention is modern forefoot surgery, for which the rasp attachment and in particular the rasp area must be designed accordingly and the shape, size, curvature, elasticity and roughness of the rasp area 50 must be optimized. For these and other surgical measures, the rasp surface or the rasp area is either placed on a convex surface as shown above in the figures or alternatively on a concave surface of the rasp attachment.

Other areas of application include maxillofacial surgery, hand surgery, neurosurgery, as well as plastic and reconstructive surgery.

As already described above, continuous rinsing of the surgical area is important to cool it and to remove the resulting debris or the removed material (for example bone meal and bone marrow cells) during the material removal process or milling process. In order to promote rinsing of the surgical area and in particular to facilitate rinsing of the rasp attachment and its rasp area, the rasp attachment and in particular its rasp area is preferably provided with a perforation or with one or more holes, slots.

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or other openings that allow the rinsing liquid to pass from one side of the rasp attachment to the other side. The convex elements 52 and the openings can be formed, for example, by punching, milling or etching U-shaped or V-shaped cuts in a sheet metal forming the rasp attachment 40 and bending up the triangular, square or semicircular sections of the sheet metal that remain within the cuts.

The fastening area of the rasp attachment according to the invention is preferably designed in accordance with the international standards for fastening surgical instruments to hand-driven or motor-driven handpieces.

As mentioned, the rasp attachment according to the invention is preferably elastic. The elasticity of the rasp attachment particularly preferably increases from the fastening device to the end facing away from the fastening device in order to achieve a good adaptation of the rasp attachment to the shape of the surface to be worked on. The elasticity is preferably higher in a front third or a third away from the fastening device than in a rear section or a section arranged close to the fastening device. An ideal adaptation or adaptability is achieved with a continuous increase in elasticity from the fastening device to the end facing away from the fastening device.

The greater the elasticity of the rasp attachment, the greater its adaptability and the better it can adapt to even small surface irregularities. The lower the elasticity of the rasp attachment, the more force or pressure the rasp attachment can exert on the surface to be treated and the smoother a surface can be treated. It is therefore suitable for every application and for every surgical area.

•t ·

A compromise must be found between elasticity and stiffness. The elasticity of the rasp attachment according to the invention is also dependent on the surgeon's preferred working technique.

Claims (12)

1. Rasp attachment ( 40 ) for a motor-driven surgical handpiece ( 70 ) with:
a fastening device ( 44 ) for fastening the rasp attachment ( 40 ) to the motor-driven surgical handpiece ( 70 ); and
a rasp portion ( 50 ) configured to remove material from a surface upon reciprocating movement of the rasp attachment ( 40 ) caused by the motor-driven surgical handpiece ( 70 ). 2. Rasp attachment ( 40 ) according to claim 1, which is curved at least in the region of the rasp area ( 50 ). 3. Rasp attachment according to claim 2, wherein the rasp region ( 50 ) is arranged on a concave or convex surface portion of the rasp attachment ( 40 ). 4. Rasp attachment ( 40 ) according to one of claims 1 to 3, which is elastically deformable at least in the region of the rasp area ( 50 ). 5. Rasp attachment ( 40 ) according to claim 4, whose elastic deformability is higher in a region remote from the fastening device ( 44 ) than in a region close to the fastening device ( 44 ). 6. Rasp attachment ( 40 ) according to claim 5, whose elastic deformability increases continuously from the fastening device ( 44 ) towards an end ( 46 ) remote from the fastening device ( 44 ). 7. Grater attachment ( 40 ) according to one of claims 1 to 6 with an elongated shape, wherein the fastening device ( 44 ) is arranged at one end ( 42 ) of the rasp attachment ( 40 ) and the rasp region ( 50 ) is arranged at the opposite end ( 46 ) of the rasp attachment ( 40 ). 8. Rasp attachment ( 40 ) according to claim 7, which is designed to remove material from the surface during a circular arc segment-shaped movement of the rasp region ( 50 ). 9. Rasp attachment ( 40 ) according to claim 7 or 8, wherein the rasp region ( 50 ) is further configured to remove material from the surface during movement of the rasp attachment ( 40 ) in the longitudinal direction. 10. Grater attachment ( 40 ) according to one of claims 1 to 9, further comprising an opening which allows a rinsing liquid to pass through the grater attachment ( 40 ). 11. Rasp attachment ( 40 ) according to one of claims 1 to 10, wherein the fastening device ( 44 ) corresponds to an international standard for surgical devices. 12. Motor-driven surgical handpiece ( 70 ) with a rasp attachment ( 40 ) according to one of claims 1 to 10.