The invention relates to a surgical punch with a tubular shaft, the distal end of which forms an annular cutting edge, a cutting member which is mounted for longitudinal displacement in relation to the shaft, interacts with the cutting edge and is held on an advancing element mounted for displacement in the tube, and an actuating member for displacing the advancing element in the shaft, this member being arranged at the proximal end of the shaft.
Surgical punches of this type are used to introduce openings into vascular walls, for example for attaching a bypass vessel. In this respect, a cutting member which can, for example, be of a conical design is brought close to a cutting edge with its circumferential edge, wherein the vascular wall is entrained between cutting member and cutting edge. As a result, a cut is made in the vascular wall along the cutting edge, i.e. circular openings can, for example, be introduced into vascular walls.
In the case of conventional instruments, a different punch has to be used for each opening size; moreover, these instruments can be used only for such a time as the cutting edge of the cutting member generates a clean cut, i.e. the cutting edge has the desired sharpness and is not damaged in any way. If the cutting edge becomes blunt or damaged, the instrument has to be replaced.