the medical cutting and / or holding instruments shown in side view in fig1 , 2 , 3 , 4 a , 5 , and 6 a consist essentially of a shaft 3 consisting of two separate shaft rods 1 and 2 , a tool 4 positioned on the distal end of the shaft 3 and consisting of two jaw members 4 a and 4 b , as well as a handle 7 positioned on the proximal end of the shaft 3 and consisting of two gripping members 5 and 6 . the medical cutting and / or holding instruments shown in the illustrations have the particularity that every gripping members 5 and 6 of the handle 7 and the particular related shaft rods 1 and 2 of the shaft 3 are configured as single unit constructions without joints . the illustrated instruments , moreover , can be divided into two groups with differently configured handles 7 , namely , first , the instruments shown in fig1 , 2 , and 3 , in which the gripping members 5 and 6 of the handle 7 , which are connected without joints with one another , form a single unit component and , second , the instruments shown in fig4 a , 5 , and 6 a , in which the gripping members 5 and 6 of the handle 7 are connected without joints to one another by a coupling element 8 . in all cases the illustrated medical cutting and / or holding instruments are distinguished in that they consist of only a few components and in the area of the handle 7 dispense completely with any complex joint mechanism . to open and close the jaw members 4 a and 4 b of the tool 4 by the handle 7 in the illustrated instruments , the gripping members 5 and 6 , either of the handle 7 produced as a single unit according to fig1 to 3 , or else the gripping members 5 and 6 of the handle 7 connected with one another by the coupling element 8 , according to fig4 a to 6 a , are configured so that they can be displaced with respect to one another by spring elasticity . the gripping members 5 and 6 , preferably produced from round or flat precious metal and connected as a single unit with the respective shaft rods 1 and 2 of the shaft 3 , are configured here in such a way that , upon clasping the handle 7 the gripping member 5 remains essentially rigid and the gripping member 6 can be drawn forward by pulling the finger against the rigid gripping member 6 . as a result of the spring elasticity of the material of the gripping members 5 and 6 that are connected with one another , the gripping member 6 immediately springs back into the illustrated starting position again . because of the single unit configuration of the gripping members 5 and 6 of the handle 7 , each with one shaft rod 1 and 2 of the shaft 3 , there results an essentially rigid shaft rod 1 , which is configured as a single unit with the rigid gripping member 5 , as well as an essentially axially movable shaft rod 2 , which is configured as a single unit with the flexibly movably gripping member 6 . as can further be seen from the side views of the various instruments , the jaw member 4 a of the tool 4 is configured rigidly as a single unit with the shaft rod 2 , which in turn is configured as a single unit with the flexibly movable gripping member 6 . the structure of the tool 4 with a rigid jaw member 4 a and a rotatable jaw member 4 b can be seen in particular in fig4 c . the jaw member 4 b configured as a rotatable tipping gear can rotate around coupling points 9 and 10 and is mounted on the rigid shaft rod 1 and the rigid jaw member 4 a , so that the coupling points 9 and 10 take the form of mounting bolts . the rotatable mounting here is configured in such a way that the rotatable jaw member 4 b is connected with the axially movable shaft rod 2 by the coupling point 9 and displacement of this shaft rod 2 causes rotation of the rotatable jaw member 4 b around the coupling point 10 on the rigid shaft rod 1 . by modifying the distance of the two coupling points 9 and 10 of the rotatable jaw member 4 b , it is possible to realize various translation ratios in order to be able to exert more or less force by the jaw members 4 a and 4 b of the tool 4 , depending on the area of application of the instrument . because the gripping members 5 and 6 , because of the spring elasticity , always more or less automatically assume the illustrated starting point in which the tool 4 is found in the open position , it can be advantageous , in particular in the configuration of the tool as a holding instrument , to provide a stopping mechanism 11 , as seen in fig3 , by which the gripping members 5 , 6 of the handle 7 and / or the shaft rods 1 , 2 , at least in a closed position of the tool 4 , can be fixed in their respective position with respect to one another . in the embodiment shown in fig3 , the stopping mechanism 11 is configured as a latch 11 a on the movable gripping member 6 , which , pre - tensioned as a stopping mechanism by a spring element 11 b , engages in a notched toothing 11 c configured in the rigid shaft rod 1 . the stopping mechanism is released in the illustrated embodiment by means of an index finger support 12 configured as a toggle switch . to facilitate gripping of the handle 7 for the operator and to ensure a secure , precise operation of the medical cutting and / or holding instrument , in keeping with the embodiment shown in fig2 the handle 7 is configured as flattened in the area of the gripping members 5 and 6 . fig4 a and 6 a show alternative embodiments for improving the maneuverability , according to which , as per fig4 a , a gripping plate 13 is secured on gripping members 5 and 6 of the handle 7 and , as per fig6 a , at least one finger groove 14 is configured on at least one gripping member 6 of the handle 7 . in addition to the previously described connection of the gripping members 5 and of the handle 7 by the coupling element 8 , the medical instruments shown in fig4 a to 6 a are distinguished from the instruments shown in fig1 to 3 in that , in addition to the use as mere cutting and / or holding instruments , they are configured in such a way that they can be used as monopolar or bipolar instruments for electro - surgery . in so - called electro - surgery , high - frequency energy is directed to the surgical area by the medical instrument and is transformed in the tissue into heat energy , so that at the transformation area , temperatures of about 60 to 100 degrees celsius occur . this electro - surgery is used for coagulating tissue and small vessels and for cutting or severing tissue . to use the illustrated medical instruments in electro - surgery , the gripping members 5 and 6 of the handle 7 are connected with a connecting plug 15 , by which the high - voltage current is introduced into the instrument and , in bipolar application , is also diverted out again . in the embodiments shown in fig4 a to 61 , the connecting plug 15 is configured as a coupling element 8 that connected the two gripping members 5 , 6 of the handle 7 to one another . in monopolar application , the desired thermal effect occurs only at the so - called active electrode , the distal end of the medical instrument . this effect is achieved when the active electrode has a clearly smaller contact surface than the so - called neutral electrode , on which the patient lies . the current flow in monopolar high - frequency ( hf ) application proceeds from a hf current source through the connecting plug 15 into the medical instrument and continues further by way of the gripping members 5 and 6 as well as the shaft rods 1 and 2 to the jaw members 4 a and 4 b of the tool 4 . upon contact by the tool 4 with the patient tissue , the current circuit closes and the entire high - frequency current required for the heat effect flows through the tissue volume to the neutral electrode . because of the small contact surface of the tool that acts as an active electrode , a high hf current density develops only in proximity to the tool and only in this same area does a heat development occur with correspondingly high temperature . in bipolar application , the hf current flows only in a tissue volume between two electrodes of equal type and equal size , namely the jaw members 4 a and 4 b of the tool 4 . the distance between the two electrodes is very small , and the hf current flows only through a relatively small tissue volume . the heat development occurs exclusively between the two electrodes , the jaw members 4 a and 4 b . the current flow , in the bipolar hf application , proceeds from a hf current source by way of the connecting plug 15 into the medical instrument and continues by way of the rigid gripping member 5 and the rigid shaft rod 1 to the rotatable jaw member 4 b of the tool 4 . as soon as both jaw members 4 a and 4 b are in contact with the patient &# 39 ; s tissue , the current circuit closes and the hf current flows through the rigid jaw member 4 a of the tool 4 further through the axially slidable shaft rod 2 and the movable gripping member 6 of the handle 7 back through the connecting plug 15 to the hf current source . to protect the operator and to protect tissue parts that are not to be handle , all current - bearing parts , including the two jaw members 4 a and 4 b of the tool 4 , are configured as electrically insulated . in the embodiment illustrated in fig6 a to 6 c the insulation is configured as a contracting hose , which completely surrounds the parts that are to be insulated , as can be seen in particular in the section views of fig6 b and 6 c . the illustrations show only schematic depictions of the insulation of the shaft rods 1 and 2 of the shaft 3 , although in practice the gripping members 5 and 6 of the handle 7 are also configured as insulated . as can be seen from the illustrations , the shaft rods 1 and 2 , which run separately from one another with the gripping members 5 and 6 of the handle 7 shaped to match them , without joints , in single unit construction , offer clearly favorable insulating conditions for use in applying and removing electric high - voltage current . to prevent premature conducting of current into the current - removing shaft rod 2 , in the embodiment shown in fig4 a to 4 d the rotatable jaw member 4 b is mounted on the rigid jaw member 4 a and on the rigid shaft rod 1 by means of an electrically insulated jointed strip 17 that is electrically insulated or that consists of an electrically non - conductive material . as can be seen in particular from the detailed views of fig4 c and 4 d , the jointed strip 17 is positioned in a longitudinal slit 18 of the rotatable jaw member 4 b , so that the high - voltage current is preferably conducted from the rigid shaft rod 1 through the mounting bolts of the coupling points 10 into the rotatable jaw member 4 b . the medical cutting and / or holding instruments that are configured as seen in the illustrations , in addition to their multilateral uses , are distinguished in that they are simply constructed to consist of only a few components . in addition to the result that such instruments can be constructed and installed simply and quickly , and thus at reasonable cost , they are all characterized by being easy to clean .
the invention relates to a medical cutting and / or holding instrument having a shaft , a tool mounted on the distal end of the shaft and consisting of two jaw members , and also having a handle that is mounted on the proximal end of the shaft , consists of two gripping members , and serves to open and close the jaw members of the tool . in order to produce a simply constructed and easily cleanable medical cutting and / or holding instrument , it is proposed according to the invention that the shaft should consist of two shaft rods , each configured without joints as a single construction with one gripping member of the handle .