CN101374466B - A device, clip, endoscope and method for the intraluminal treatment of tissue, e.g. hemorrhoids - Google Patents
A device, clip, endoscope and method for the intraluminal treatment of tissue, e.g. hemorrhoids Download PDFInfo
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- CN101374466B CN101374466B CN2006800528054A CN200680052805A CN101374466B CN 101374466 B CN101374466 B CN 101374466B CN 2006800528054 A CN2006800528054 A CN 2006800528054A CN 200680052805 A CN200680052805 A CN 200680052805A CN 101374466 B CN101374466 B CN 101374466B
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Abstract
A device for the intraluminal treatment of tissue comprises a handle, a shaft which extends from the handle and a head arranged at the distal end of the shaft, wherein the head comprises at least one jaw, movable between an open position, wherein it defines a window for the insertion of the tissue and surrounding tissue, and a closed position, and wherein the shaft extends between the handle and head in a curvilinear longitudinal direction.
Description
Technical field
The present invention relates to a kind of equipment, anchor clamps, anoscope and method that is used for the intracavitary therapy tissue, for example be used for the transanal therapy of hemorrhoid or be used for its hetero-organization that is different from hemorrhoid is carried out intracavitary therapy or endoscope treatment.
Another object of the present invention provides a kind of endoscope, for example is used for the treatment of the lower rectum pathologies anoscope of (for example being used for the minimally invasive surgery treatment of hemorrhoid).
Except its hetero-organization that is different from hemorrhoid being carried out the endoscope of intracavitary therapy, these aspects of the present invention relate in particular to the realization of minimally invasive surgery treatment internal hemorrhoid, and so-called internal hemorrhoid promptly is positioned at the above hemorrhoid of anal orifice and rectal intestine intersection (pectinate line).
Background technology
The method of known a kind of surgical intervention hemorrhoid is the methods that adopt the caoutchouc elasticity band to carry out the hemorrhoid ligation, and in this method, each hemorrhoid is inserted in the hollow cylinder device, and the caoutchouc elasticity band is set on hemorrhoid.The thrust that produces by elastic webbing causes tissue necrosis and comes off.
But the equipment of this method and employing thereof has some shortcomings.Particularly, the caoutchouc elasticity band can not be implanted the root of hemorrhoid deeply, and because the elasticity of itself makes it can be adapted to tissue, therefore causes hemorrhoid not effected a radical cure.
Also known in addition a kind of method (being known as mucosa suture (PPH) on the anastomat hemorrhoid) and this method application corresponding equipment.This equipment is made up of circular stapler basically, and this stiching instrument can be inserted in the anal canal, and circular resection comprises the tissue of hemorrhoid after stablizing.In this case, excision can have influence on the whole cross section of anal canal and can produce sizable wound.
Summary of the invention
The purpose of this invention is to provide a kind of equipment, anchor clamps and method that is used for the intracavitary therapy tissue, for example be used for the transanal therapy hemorrhoid or be used for intracavity or endoscope treatment is different from its hetero-organizations of hemorrhoid, the feature on the 26S Proteasome Structure and Function of the said equipment, anchor clamps and method can overcome above-mentioned deficiency of the prior art.
This problem can by according to claim 1 or 16 described for the intracavitary therapy bodily tissue equipment of (as being used for the transanal therapy hemorrhoid or being used in the chamber or endoscope treatment is different from the bodily tissue of hemorrhoid), according to claim 7 for the anchor clamps of intracavitary therapy bodily tissue (as being used for the transanal therapy hemorrhoid or being used in the chamber or endoscope treatment is different from the bodily tissue of hemorrhoid) and according to claim 21 or 42 described methods for intracavitary therapy bodily tissue (as being used for the transanal therapy hemorrhoid or being used in the chamber or the endoscope internal therapy is different from the bodily tissue of hemorrhoid) solve.
Another object of the present invention provides a kind of endoscope, such as effective anoscope easy to use, it is specially adapted to be used in the systemic method of intracavitary therapy with equipment above-mentioned, and for example the method for transanal therapy hemorrhoid or intracavity or endoscope treatment are different from the systemic method of hemorrhoid.
This problem is to solve as the anoscope that is used for lower rectum pathologies by the endoscope that is used for the treatment of the pathology of human body or the natural pipeline of animal body according to claim 28, for example is used for the endoscope of minimally invasive surgery treatment hemorrhoid.
Description of drawings
According to other feature and advantage of equipment of the present invention, anchor clamps, endoscope or anoscope and method by preferred implementation (being related to the application when the treatment hemorrhoid below with reference to accompanying drawing, but be not limited thereto kind of an application) description will become clearer, but it only plays illustration, be not used for limiting, wherein:
Fig. 1 represents a kind of axonometric chart of embodiment of the equipment of transanal therapy hemorrhoid;
The detailed view of the amplification of equipment shown in Fig. 2 presentation graphs 1;
The detailed view of the amplification of a kind of possible embodiment of equipment shown in Fig. 3 presentation graphs 1;
Fig. 4 illustrates the details of Fig. 3 from different perspectives;
Fig. 5 illustrates the details of Fig. 3 from different perspectives, shown in this figure and the bonded situation of anoscope of the present invention;
Fig. 6 shows details shown in Figure 5 and anoscope from different perspectives;
Fig. 7 represents the axonometric chart of anoscope of the present invention;
The side view of anoscope shown in Fig. 8 presentation graphs 7;
The perspective view of anoscope shown in Fig. 9 presentation graphs 7;
Figure 10 represents the three-dimensional exploded view of a kind of possible embodiment of anchor clamps of the present invention;
Figure 11 represents the axonometric chart of a kind of possible embodiment under first kind of service condition of anchor clamps of the present invention;
Figure 12 is illustrated in the anchor clamps shown in Figure 11 under second kind of service condition;
Figure 13 represents the enlarged drawing of a kind of possible embodiment of the details of equipment of the present invention;
Figure 14 represents the sectional view of anal canal;
Figure 15 represents the longitudinal cross-section of rectum;
Figure 16-18 is illustrated respectively in the sequenced step of method of the present invention, the view of details shown in Figure 15.
The specific embodiment
With reference to above-mentioned accompanying drawing, the equipment of transanal therapy hemorrhoid is represented with label 10 on the whole.This equipment comprises handle 12 and the axle 14 that extends from this handle.Head 16 places the far-end of described axle, promptly away from holding this equipment and operating the surgeon or the operator's of this equipment end.
Described head 16 comprises at least one jaw 18, and it can move between open position and make position, and when jaw 18 was shown in an open position, it defined window 20, is used to make hemorrhoid and surrounding tissue to insert wherein.
According to the preferred implementation of expression in the diagram, at the open position of jaw 18, described window 20 is laterally opened.
Represent with label 22 with described moveable jaws opposed jaws.In this embodiment, this opposed jaws is fixed, and is positioned at the distally of this moveable jaws.In other embodiments, might two jaws all be movable, perhaps the location swap of this moveable jaws and this opposed jaws can be predicted the distal position that this moveable jaws is positioned at opposed jaws.
Advantageously, axle 14 can extend with curve between described handle and head along the longitudinal direction.
Advantageously, described head, particularly two jaws have curvilinear structures.
According to one embodiment of the present invention, described equipment 10 is linear or the stiching instrument of curve slightly.Described head comprise at least one row can the fastening hemorrhoid and surrounding tissue so that thereby coagulation of tissues reaches hemostatic clamping element or seam nail 24.Preferably, when making again, head stitches nail catcher on hemorrhoid after open position moves to make position.Especially, described handle comprises first parts that are used for closed jaw and will stitch nail catcher and is tightened to structural second parts.In another embodiment, described seam nail fastens to tissue by head moving from the open position to the make position.
Preferably, the tight element 24 of at least two row foldings is arranged, they are provided with basically in parallel to each other.Also probable to aware has the tight element of many row foldings.
In this embodiment, clamping element is arranged in the moveable jaws 18, and opposed jaws in the moving process of make position, forces clamping element crooked and be close to tissue at from the head open position.
According to a kind of possible embodiment, adjacent with the tight element of at least one row folding 24 also further have a cutter 26, is used for cutting hemorrhoid and surrounding tissue.Preferably, this cutter is positioned at and is suitable for being fastened near the structural row's seam nail of anal canal side.This cutter is suitable for excising the tissue of hemorrhoid side, and originally arranges without any the seam nail on one's body in hemorrhoid.Thereby the tissue of anal canal condenses by the seam nail and stops blooding.In different embodiments, under the situation that two or more rows clamping element 24 is arranged, described cutter can be arranged between two rows, thereby first row's seam nail belongs to the tissue that need remove, and second row's seam nail belongs to anal canal tissue.
In different embodiments, described equipment 10 comprises head, and it is used for holding at least one anchor clamps 28 and is tensioned on the hemorrhoid by described window.In other words, described head (can be curve) does not comprise a plurality of clamping elements or seam nail, holds anchor clamps between the jaw but be arranged in.
Possibly, described head comprises that further cutter 26 cuts hemorrhoid and the surrounding tissue that compressed by anchor clamps.
The anchor clamps 28 that are used for the transanal therapy hemorrhoid comprise two complementary elements 30,32, and these two complementary elements 30,32 are suitable for locking mutually at least one compacted position of hemorrhoid and surrounding tissue.Preferably, described anchor clamps 28 comprise two complementary curve elements 30,32 in the head of the equipment that is suitable for being contained in aforementioned transanal therapy hemorrhoid.
According to first kind of embodiment, anchor clamps 28 comprise first element 30, and it is provided with the stop pin 34 at least one respective seat that can be inserted into second element 32 36.Described seat 36 comprises at least one flexible member 38, and stop pin 34 is made into the shape in can snap lock present 36.
Possibly, first element 30 and second element 32 comprise guide 40 and slide 42 respectively, are used to make two elements 28 and 30 to locate mutually.
Advantageously, complementary element 30,32 comprises the mutual pressing section 44 that is used for hemorrhoid and surrounding tissue.According to first kind of embodiment, under the situation that does not have cutter 26, pressing section is used for producing the necrosis of tissue.
According to second kind of embodiment, complementary element 30,32 is hinged and remains closed by at least one flexible member 46, and this flexible member 46 preferably is arranged on hinge 48 places.During insertion, complementary element 30,32 jaws by head stay open.
Equally in this case, pressing section 44 also is used as and fastens clamping part to close on hemorrhoid and the surrounding tissue mutually.
Advantageously, have complementary element 30,32 in description and the illustrated embodiment, wherein, at least one part realizes with biocompatible materials.Preferably, adopt the part of biocompatible materials to be arranged on two pinch zones or join domain place (are pin or hinge for such anchor clamps) between the complementary elements.
According to another embodiment, the present invention relates to a kind of equipment 10 of transanal therapy hemorrhoid, it comprises handle 12, the axle 14 that extends from this handle 12 and the head 16 that places a far-end.Described head 16 comprises at least one jaw 18, and it can move between open position and make position, and when it was shown in an open position, it defined the window 20 that is used to insert hemorrhoid and surrounding tissue.Especially, described head is realized in the manner described before, promptly comprises and this movable jaw opposed jaws 22.In this embodiment, described opposed jaws is fixed and is positioned at the distally of moveable jaws.In this embodiment, may described two jaws all be movable, perhaps to be positioned at the distally of opposed jaws also be possible to both out of position and moveable jaws.
In this embodiment, clamping element does not appear in the described head.In fact, described axle and head advantageously comprise and are used for applying energy to cut and to make the parts 50 of coagulation of tissues to hemorrhoid and other surrounding tissues.According to this embodiment, described axle can extend with curve between handle and head along the longitudinal direction.And described head, particularly jaw can be curvilinear structures.
According to first kind of embodiment, the equipment that is used to apply energy comprises ultrasonic device.Alternatively, this equipment that is used to apply energy comprises laser equipment.
According to an other feature, the present invention relates to a kind of method of transanal therapy hemorrhoid.
Under normal conditions, this method may further comprise the steps:
The window 20 that the head 16 of the equipment by being used for the transanal therapy hemorrhoid by this limits promptly and the tractive hemorrhoid;
Closed jaw 18,22, locking hemorrhoid and surrounding tissue;
Tissue part is accumulated in wherein tissue can be locked in the zone between the jaw.
Further, can also advantageously comprise the step that cuts and organizes and described tissue is shifted out from this position by jaw.
According to a kind of possible embodiment, described tissue part is collected in the zone, and in this zone, tissue can be locked between the jaw by tight element of at least one row folding or seam nail.Preferably, after open position moved to make position, described seam nail catcher was tightened to described tissue at jaw.
According to different embodiments, described tissue part is assembled wherein organizes the zone that can be locked in by the location of foregoing anchor clamps between the jaw.
In another embodiment, described tissue part is collected in the zone, and in this zone, tissue can cut and organize by the applying in the zone that is locked between the jaw of energy (being preferably ultrasonic or laser) simultaneously.
Describe the step of transanal therapy hemorrhoid method of the present invention below in detail:
The patient can be in a conventional manner or the mode liked of doctor prepare for operation and locate.Operative region is also carried out traditional preparation, and a step is to anaesthetize, for example spinal anesthesia or general anesthesia.
Carry out the visual inspection of anal canal and anus surrounding tissue, carry out digital rectal examination subsequently,, also may check and record other pathological changes to assert and to distinguish internal hemorrhoid.
Insert anoscope then.
Grasp internal hemorrhoid by the parts such as tweezers that are positioned at the non-infected area of patient.
Insert the equipment that is used for the transanal therapy hemorrhoid then, by the window tractive hemorrhoid on this equipment.Closed then jaw, thereby locking hemorrhoid and surrounding tissue.
As previously mentioned, when this equipment was stiching instrument, preferably after the jaw closure, clamping element passed tissue and inserts also closure, and the operation cutter is with the cutting hemorrhoid.Remove cut tissue then.Preferably, the seam nail catcher condenses to make this portion of tissue at least to the tissue of anal canal.
As previously mentioned, under the situation of using anchor clamps, anchor clamps are placed in the window place that opens earlier, by described window and open anchor clamps tractive tissue.The closure of jaw causes that anchor clamps are locked on the hemorrhoid.In this case, this equipment also may comprise cutter, and therefore the tissue that compressed by anchor clamps can be cut and remove.Alternatively, also can not cut away tissue, but come off by the necrosis of pressurized zone.Under the situation of using biocompatible materials, in case task is finished, anchor clamps just come off or are absorbed.
At last, be used to apply in use under the situation of parts of energy, after the jaw closure, operate these parts (laser or ultrasound wave) and come calcination and cut and organize.
Remove equipment then, also may related cut organizing together remove.
Next, to the inspection of stopping blooding of cut point and anorectum intersection.If check satisfactoryly, remove anoscope.
At last, in rectum, insert sponge.
According on the other hand, the present invention relates to a kind of anoscope that is used for the treatment of lower rectum pathologies, for example the anoscope that particularly uses as previously described treatment hemorrhoid.
Anoscope of the present invention represents that with 52 it comprises insertion portion 54 and outside or grip portions 56.
This insertion portion comprises in a tubular form the wall basically that extends of part 54b distad from portions of proximal 54a.Described distal part is advantageously implemented as frusto-conical, has less cross section at the far-end of anoscope.
Further, described tubular wall comprises window 58, the use that it for example can be observed hemorrhoid and allow above-mentioned apparatus.Especially, window 58 relates to the mid portion 54c and the distal part 54b of insertion portion, and window 58 is opened on the far-end of anoscope.Advantageously, window 58 does not extend to the portions of proximal 54a of insertion portion.In other words, described portions of proximal 54a is along circumferentially extending on 360 ° continuously, with protection anorectum junction in operation.
According to a kind of possible embodiment, window 58 has a curved edge, and being at least has a curved edge in the mid portion 54c of insertion portion, along with from the portions of proximal of anoscope moving of part distad, at least up to the starting point of distal part, this window 58 broadens slightly.
Advantageously, according to a kind of possible embodiment, described insertion portion at least to the starting point of distal part, has variable diameter from the portions of proximal to the distal part.Particularly, the transverse dimension d 2 (diameter) of the point measurement of portions of proximal less than the starting point of distal part (term " starting point " be about from the portions of proximal of anoscope distad moving of part use) transverse dimension d 1 (diameter) of measurement.
Passage from size d1 to d2 can form by curved profile, perhaps is more preferably linear profile.
Preferably, anoscope is made with transparent material, thereby the anorectum boundary line is under the observation always.
As for grip portions 56, advantageously can have two edges of a wing 60 at least, with the operation that allows anoscope with around the circumferential possible rotation of anus wall/rectal wall with respect to the longitudinal extension part horizontal expansion of insertion portion.Advantageously, in anoscope one side two radially edges of a wing of biasing relatively and slightly can be arranged.
The size of the size of anoscope, particularly insertion portion can be used above-described apparatus and is avoided sphincter is caused damage.
With reference to the use of anoscope, particularly above-described anoscope, the method for aforementioned transanal therapy hemorrhoid is particularly including following steps:
For patient and operative region are prepared;
Anaesthetize, for example spinal anesthesia or general anesthesia;
Anal canal and perianal tissue are carried out visual inspection, carry out digital rectal examination subsequently, assert and distinguish internal hemorrhoid;
Insert anoscope, particularly aforesaid anoscope;
Preferably locate a uninfluenced zone on one's body the patient;
At the domestic equipment that is used for the transanal therapy hemorrhoid that inserts of anus, particularly foregoing equipment, and it is outstanding to make head 16 pass window 58;
Pass anoscope window and described device window tractive hemorrhoid;
Closed jaw, thereby locking hemorrhoid and surrounding tissue.
When described equipment was stiching instrument, as previously mentioned, clamping element or seam nail passed tissue and insert also closure, and preferably, after open position moved to make position, the operation cutter cut hemorrhoid at head.By from anoscope, pulling out cut tissue it is removed.
Under the situation of using anchor clamps, as previously mentioned, anchor clamps are placed in the window place that opens earlier, and described tissue is subjected to tractive by anoscope window, device window and open anchor clamps.The closure of jaw is locked on the hemorrhoid anchor clamps.In this case, this equipment also may comprise cutter, thereby cuts and remove by anoscope with the tissue that this cutter will be compressed by anchor clamps.Alternatively, also can not cut away tissue, and come off by the necrosis of pressurized zone.Under the situation of using biocompatible materials, in case task is finished, anchor clamps just come off or are absorbed.
At last, be used to apply in use under the situation of parts of energy, after the jaw closure, operate these parts (laser or ultrasonic) and come calcination and cut and organize.
Remove equipment then, also may related cut organizing together remove, next anoscope also is removed.In rectum, insert sponge possibly.
From as can be known above, adopt method of the present invention will bring result more completely, and can not cause big wound at the circumference of whole anal canal.
Above-described equipment, anchor clamps and anoscope have been simplified operating process, have reduced patient's risk.And they have eliminated each one hemorrhoid, may need ensuing several operating procedure to avoid the patient is caused extra discomfort.
Described seam nail line and anchor clamps are suitable for being properly oriented.Compare with using elastic webbing, they can be positioned deeplyer by the hemorrhoid traction.And their location is more guaranteed, and is all highly stable in whole surgery process or post-operative course.
Clearly, conversion and/or the increase that top description and example are carried out is predictable.
For example, aforesaid equipment can extend along the longitudinal direction with curve, and comprises one or more sweeps.
More than be at preferred implementation, but they also are suitable for systemic intracavitary therapy substantially, for example also are suitable for being different from other systemic treatments of hemorrhoid about equipment, anchor clamps, method or the anoscope of hemorrhoid treating.Those skilled in the art can carry out various modifications, distortion and alternative to element with the element of other functional equivalents, but all not exceed the scope of following claim in order to satisfy corresponding and concrete needs.
Claims (10)
1. one kind is used for the systemic anchor clamps of intracavitary therapy, the complementary elements (30 that comprises two curves, 32), described complementary elements can lock at least one compacted position of tissue to be treated and surrounding tissue mutually, described complementary elements can be contained in a head (16) that is used for the equipment (10) of intracavitary therapy tissue, it is characterized in that, described complementary elements (30,32) comprise the mutual pressing section (44) that is used for described tissue to be treated and surrounding tissue, wherein, described mutual pressing section can produce the necrosis of tissue, described complementary elements (30,32) by being arranged on described complementary elements (30,32) two of opposite end hinges (48) are hinged, and remain closed by being arranged on the flexible member (46) that described hinge (48) locates, thus, described mutual pressing section (44) is used as the fastening clamping part.
2. anchor clamps according to claim 1 is characterized in that described complementary elements is hinged, and remain closed by at least one flexible member, and this flexible member is arranged on the hinge place.
3. anchor clamps according to claim 2 is characterized in that, described complementary elements comprises and compresses and fasten clamping part mutually, to close on tissue to be treated and the surrounding tissue.
4. anchor clamps according to claim 1 is characterized in that at least a portion of described complementary elements is made with biocompatible materials.
5. anchor clamps according to claim 4 is characterized in that, at least a portion of the described complementary elements of being made by biocompatible materials is arranged on two clamping or join domain places between the described complementary elements.
6. one kind is used for the systemic equipment of intracavitary therapy, comprise handle, from the axle of described handle extension and the head that is arranged on the far-end of described axle, described head comprises at least one jaw, described jaw can move between open position and make position, when described open position, described jaw is defined for the window that inserts tissue to be treated and surrounding tissue, wherein said axle and head comprise and are used for applying energy with the cutting and the parts of described tissue to be treated and surrounding tissue that condense to tissue to be treated and surrounding tissue, wherein, comprise the systemic anchor clamps of intracavitary therapy that are used for as claimed in claim 1 in the described head.
7. equipment according to claim 6 is characterized in that, described axle extends between described handle and head along the longitudinal direction with curve.
8. equipment according to claim 6 is characterized in that described head has curvilinear structures.
9. equipment according to claim 6 is characterized in that, describedly is used for applying energy to tissue to be treated and surrounding tissue and comprises ultrasonic parts with the parts of cutting and condense described tissue to be treated and surrounding tissue.
10. equipment according to claim 6 is characterized in that, describedly is used for applying energy to tissue to be treated and surrounding tissue and comprises laser part with the parts of cutting and condense described tissue to be treated and surrounding tissue.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| ITMI20060281 ITMI20060281A1 (en) | 2006-02-15 | 2006-02-15 | ANOSCOPE CLAMP AND MEETHOD DEVICE FOR TRANSANAL HEMORROID TREATMENT |
| ITMI2006A000281 | 2006-02-15 | ||
| ITMI20060509 ITMI20060509A1 (en) | 2006-03-21 | 2006-03-21 | ANOSCOPE CLAMPING DEVICE AND METHOD FOR TRANSANAL HEMOROID TREATMENT |
| ITMI2006A000509 | 2006-03-21 | ||
| PCT/EP2006/007355 WO2007093198A1 (en) | 2006-02-15 | 2006-07-26 | A device, clip, endoscope and method for the intraluminal treatment of tissue, e.g. hemorrhoids |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101374466A CN101374466A (en) | 2009-02-25 |
| CN101374466B true CN101374466B (en) | 2011-07-27 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2006800528054A Active CN101374466B (en) | 2006-02-15 | 2006-07-26 | A device, clip, endoscope and method for the intraluminal treatment of tissue, e.g. hemorrhoids |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN101374466B (en) |
| IT (1) | ITMI20060281A1 (en) |
Families Citing this family (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP2563234B1 (en) * | 2010-04-26 | 2021-12-08 | Covidien LP | Apparatus for effecting at least one anatomical structure |
| CN102652683A (en) * | 2012-04-13 | 2012-09-05 | 北京中法派尔特医疗设备有限公司 | Cartridge assembly and bladed stitching instrument using cartridge assembly |
| US11678786B2 (en) * | 2019-07-16 | 2023-06-20 | Boston Scientific Scimed, Inc. | Device and methods for inspection and treatment of hemorrhoids |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1636522A (en) * | 2003-07-09 | 2005-07-13 | 伊西康内外科公司 | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
-
2006
- 2006-02-15 IT ITMI20060281 patent/ITMI20060281A1/en unknown
- 2006-07-26 CN CN2006800528054A patent/CN101374466B/en active Active
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN1636522A (en) * | 2003-07-09 | 2005-07-13 | 伊西康内外科公司 | Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis |
Also Published As
| Publication number | Publication date |
|---|---|
| ITMI20060281A1 (en) | 2007-08-16 |
| CN101374466A (en) | 2009-02-25 |
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