JPH0833642A - 外科用ステープラのための改良アンビル承口 - Google Patents
外科用ステープラのための改良アンビル承口Info
- Publication number
- JPH0833642A JPH0833642A JP7058161A JP5816195A JPH0833642A JP H0833642 A JPH0833642 A JP H0833642A JP 7058161 A JP7058161 A JP 7058161A JP 5816195 A JP5816195 A JP 5816195A JP H0833642 A JPH0833642 A JP H0833642A
- Authority
- JP
- Japan
- Prior art keywords
- staple
- jaw member
- anvil
- cam
- propulsion
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07257—Stapler heads characterised by its anvil
- A61B2017/07264—Stapler heads characterised by its anvil characterised by its staple forming cavities, e.g. geometry or material
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
部材の一方は、少なくとも一つの行において配置した複
数のステープルを収容するように適合されたステープリ
ング保持手段を含み、そして他方のあご部材は、ステー
プルを形成するために適合された適応改良アンビル手段
を含む第1及び第2協働伸長あご部材と、組織において
少なくとも一つのステープル行を生成するためにステー
プル保持手段からあご部材の間に把持した組織にステー
プルを駆動し、アンビル手段に対してステープルを形成
するための推進手段と、ステープル行に隣接した線に沿
ってあご部材の間に把持した組織を切断するためのナイ
フ手段と、ステープルが形成される時、ステープル保持
手段とアンビル手段に及ぼされた力を阻止するようにあ
ご部材に締付け力を加えるためのあご締付け手段とを具
備する。 【効果】 ステープルを容易に設置できる。
Description
に関し、そしてさらに詳細には、ステープルが形成され
る時、一行以上のステープルを生成するための胃腸吻合
ステープリング器具に関する。
道、胃、十二指腸及び他の身体器官の如く身体器官と組
織を縫合するために、外科医がステープリング器具を使
用する傾向が増大した。多くの事例における適切なステ
ープリング器具の使用は、より少ない時間でより良い仕
事を行い、胃腸吻合の如く以前に困難であった手技を簡
単化する。
具は、一対の協働伸長あご部材を含み、各部材は、吻合
される内部管状身体器官に挿入されるために適合され
る。あご部材の一方は、少なくとも2つの横に離間した
ステープル行を有するステープルカートリッジを支持
し、そして他方のあご部材は、カートリッジにおけるス
テープルの行と整列したステープル形成承口を具えるア
ンビルを支持する。一般に、単一推進バー及びナイフ組
立品は、あご部材に沿って縦に滑動可能であり、カート
リッジによって保持された複数のステープルドライバー
を活動化するカミング表面を介してカートリッジからス
テープルを順次に放出し、ステープルドライバーは、ア
ンビルに対してステープルを閉鎖させ、あご部材の間に
把持した組織において横に離間したステープル行を形成
するために個々のステープルに関連する。推進バーの跡
を追うナイフ刃は、ステープル行の間の線に沿って組織
を切断する。しかし、アンビル承口において相互に接触
するステープラ点の準備は、一般ステープラにおいて為
されていない。
テープリング器具は、第1及び第2協働伸長あご部材を
具備し、あご部材の一方は、少なくとも一行において配
置された複数のステープルを収容するために適合された
ステープリング保持手段を含み、そして他方のあご部材
は、ステープルを形成するために適合された適応改良ア
ンビル手段と、ステープル保持手段からあご部材の間に
把持した組織にステープルを駆動し、組織において少な
くとも一つのステープル行を生成するためにアンビル手
段に対してステープルを形成するための推進手段と、ス
テープル行に隣接する線に沿ってあご部材の間に把持し
た組織を切断するためのナイフ手段と、ステープルが形
成される時、ステープル保持手段とアンビル手段に及ぼ
された力を阻止するように締付け力をあご部材に加える
ためのあご締付け手段とを含む。改良アンビル手段は、
ステープルをより容易に形成することができ、横又は深
さ方向において歪曲面を具備し、ステープル点は、形成
により常に相接を失う。
るための特別に修正したアンビルが記載される。もちろ
ん、ここで開示された実施態様は直線ステープラである
が、任意の形式のステープラが、この発明で使用するた
めに可能であることが認識される。こうして、ステープ
ラは、円形断面であり、単一ステープル行を適用し、又
はこの発明の範囲から逸脱することのない他の実施態様
である。
伸長アンビル保持あご部材22と下側伸長ステープルカ
ートリッジ保持あご部材24を具備する、一般に20の
直線吻合ステープリング器具において具現される。上側
アンビル保持あご部材22は、取手26によって支持さ
れ、あご部材の前部は前方に延びる。下側ステープルカ
ートリッジ保持あご部材24は、取手28によって支持
され、あご部材の前部は前方に延びる。図3に示された
如く、上側取手26と下側取手28は、外科医によるス
テープリング器具の取扱いと操作を容易にするための握
りを形成するように適切に形状付けられる。拡大前方隆
起部27と小さな後方隆起部29は、この目的のために
各取手において設けられる。好ましくは、取手26と2
8は、プラスチック又は他の軽量材料から作られるが、
あご部材22と24は、ステンレス鋼又は他の類似の材
料から作られる。
は、頂壁31によって連結した一対の対向伸長側壁30
を含む一片伸長溝形状フレームを具備する。上側取手2
6は、その前端に隣接する上側取手内に位置する一対の
従属する耳部32を含む。上側あご部材22は、従属す
る耳部32が下方に突出する頂壁31に沿った中間位置
に形成した溝穴34(図4)を含む。ラッチピン36
は、上側あご部材を上側取手26に旋回連結するため
に、上側あご部材22の側壁に形成した円形穴と、従属
する耳部32に形成した円形穴とを貫通する。
部には、ステープリング器具のアンビル40を規定する
一対の伸長する内向きフランジ38を設けてある。フラ
ンジ38は、アンビル40の全長に沿って中央縦溝穴4
2によって分離される。中央溝穴42の近位端部におい
て、フランジ38は、内側に傾斜した案内表面41を備
える。各フランジ38はまた、一様に離間したステープ
ル形成承口44の2つの縦行を備える。
先端46は、中空管状身体器官へのあご部材の挿入を容
易にするためにアンビル保持あご部材22の前部に取付
けられる。アンビル先端46は、上側あご部材の側壁3
0とフランジ38によって規定したアンビル40の上の
縦通路を通って挿入される伸長本体48(図4)を含
む。この伸長本体48は、ラッチピン36の上の従属す
る耳部32の間にあり、アンビル先端46を上側あご部
材22において適所に保つために耳部32の背後に位置
する拡大後部50を含む。
ジ保持あご部材24は、底壁53によって連結した一対
の対向伸長側壁52を含む一片伸長溝形状フレームを具
備する。下側あご部材24の後部に沿って、一対の離間
した伸長直立側方フランジ54(図2)が、その対向側
壁52から上方に延びる。図5と図6に示された如く、
側方フランジ54の間の下側あご部材24の幅は、ステ
ープリング器具が操作のために組み立てられた時、上側
あご部材の後部を下側あご部材の側方フランジ54の間
に収容させるために、その側壁30の間の上側あご部材
22の幅よりも大きい。図2に示された如く、下側あご
部材24の各側方フランジ54は、上側あご部材22に
おけるラッチピン36と整列して位置する垂直切欠き5
6を含む。上側あご部材22と下側あご部材24は、組
み立てられ、ラッチピン36の対向端部は、切欠き56
において収容される。
24は、少なくとも2つの横に離間した縦行において配
置した複数の手術用ステープル61(図18)を収容す
るように適合されたステープルカートリッジ60を支持
する。ステープルカートリッジ60は、その側壁52の
間の下側あご部材24の前部において取付けられる。ス
テープルカートリッジ60は、カートリッジの近位端部
からその遠位端部の方にわたる中央伸長溝穴62(図
6)によって縦に分割される。好ましくは、ステープル
カートリッジ60において形成した複数のステープル開
口64は、2対の横に離間した行において配置され、行
の各対は、中央縦溝穴62の対向側において配設され
る。複数の外科用ステープル61(図18)が、カート
リッジ60の開口64内に取付けられる。図6に示され
た如く、隣接行におけるステープル開口64は、器具が
操作される時、組織のより効果的なステープリングを設
けるために互い違いにされる。図15と図16を参照す
ると、ステープルカートリッジ60は、伸長中央溝穴6
2の対向側に位置し、中央溝穴の各側において開口64
の互い違いの行の間に配設した一対の縦溝穴66を含
む。各縦溝穴66は、カートリッジ60の近位端部から
その遠位端部の方にわたる。
ドライバー65は、ステープルカートリッジ60に装填
されたステープルを作動させるためにステープル開口6
4において滑動可能に取付けられる。図6を参照する
と、各ステープルドライバー65は、ステープルカート
リッジ60に設けた隣接行において位置する2つのステ
ープル61を同時に作動させるように設計される。こう
して、ステープルドライバー65の第1セットは、中央
縦溝穴62の一方の側に位置する互い違いの行における
ステープル61を作動させるために設けられ、そしてス
テープルドライバー65の第2セットは、中央縦溝穴6
2の他方の側に位置する隣接行の対におけるステープル
61を作動させるために設けられる。
ートリッジ60の前方又は遠位端部は、中空管状身体器
官への下側あご部材24の挿入を容易にするためのテー
パ先端68を含む。テーパ先端68のすぐ背後に、ステ
ープルカートリッジ60は、下側あご部材24の側壁5
2に設けた対応する切欠きにおいて収容された一対の後
向き突起70(一つが図14に示される)を備える。ス
テープルカートリッジ60の後部において、一対の従属
する腕72が、カートリッジから下方に進展する。各腕
72は、側方開口74を設けるために切欠きにされる。
カートリッジ60が下側あご部材24において組み立て
られる時、突起70は、側壁52の前方端部において設
けた対応する切欠きにおいて収容され、そして従属する
腕72は、あご部材24の底壁53において形成した開
口76(図4)を通って下方に進展する。下側あご部材
24は、開口76の対向側における側壁52から下向き
の従属耳部78(図19)を含む。ピボットピン80
は、下側あご部材にステープルカートリッジを締結する
ために、下側あご部材24の従属耳部78において形成
した穴と、下側あご部材24の側方開口74と、ステー
プルカートリッジ60における従属腕72の側方開口7
4とを貫通する。
0は、上側あご部材22と下側あご部材24をあご部材
に沿った中間位置においてラッチするために、一般に9
0のラッチ機構を含む。好ましくは、あご部材22と2
4は、アンビル40とステープルカートリッジ60の近
位端部に隣接した位置において一緒にラッチされる。好
ましい実施態様において、ラッチ機構90は、ピボット
ピン80(図4)を介して、下側あご部材23に旋回連
結したラッチ腕92(図2)を具備する。ラッチ腕92
は、溝形状の構成であり、そして下側あご部材24の側
壁52にわたるために十分な距離だけ離間した一対の対
向伸長側壁90(図6)を含む。ラッチ腕92の各側壁
94は、ラッチピン36を収容するための前向き溝穴9
8を具える上方前方を向くフック部材96を含む。側板
100は、ラッチ腕92の下面に取付けられる。ラッチ
腕92が、図3に示された如く閉じられた時、側板10
0は、外科医によるステープリング器具20の取扱いと
操作を容易にするために下側取手28の底部と整列す
る。好ましくは、側板100は、プラスチック又は他の
軽量材料から作られるが、ラッチ腕92は、ステンレス
鋼から作られる。図7に示された如く、側板100は、
ラッチ腕92をラッチ位置から非ラッチ位置に下向きに
旋回させるためのつかみとして役立つ、その対向側から
外向きの伸長フランジ102と104を含む。ラッチ腕
92がその閉又はラッチ位置に移動される時、フック部
材96の溝穴98の表面は、ラッチピン36と協働し、
そのラッチ位置においてラッチ腕92を維持するための
オーバーセンタラッチとして作用する。
グ器具20の好ましい実施態様は、ステープルカートリ
ッジ60からあご部材の間に把持した組織にステープル
61を駆動し、アンビル40に対してステープル61を
形成し、組織において形成したステープルの行の間の線
に沿って組織を切断するために、それぞれ、上側及び下
側あご部材22と24に関する縦移動のために滑動可能
に取付けた、一般に110の改良推進バー及びナイフ刃
組立品を含む。推進バー及びナイフ刃組立品110は、
その直立側方フランジ54の間で下側溝形状あご部材2
4内にすべり可能に収容された推進ブロック112(図
6)を含む。図11に示された如く、推進ブロック11
2は、その頂面において縦向き切欠き119を具える横
に突出する指状物118を含むフランジ116によって
作動器ノブ114に装着される。指状物118は、推進
ブロック112と作動器ノブ114を固着するために、
縦ロッキングバー121の下に切欠き119を位置させ
るために推進ブロック112において形成した横溝穴1
20に嵌着される。作動器ノブ114のフランジ116
は、下側あご部材24の一方の側方フランジ54におい
て形成した伸長溝穴122(図2)を貫装する。
進ブロック112から前方に突出し、ステープルカート
リッジ60の伸長溝穴66(図16)においてすべり可
能に収容された一対のステープル推進バー124(図1
0)を含む。推進ブロック112は、推進バー124が
固着された、一対の垂直溝穴126(図11)を備え
る。図10に示された如く、各ステープル推進バー12
4の前方端部は、推進バー124がステープルカートリ
ッジ60内へ進められる時、ステープルドライバー65
に係合するための傾斜カム表面130を規定するくさび
形状先端128を備える。図21に示された如く、各ス
テープルドライバー65は、表面の間に平すべり接触を
設けるために、各ステープル推進バー124のカム表面
130と同一の角度において方向付けられた傾斜面13
2を備える。
ナイフ刃組立品110は、直立側方フランジ54の間の
下側あご部材24に沿った縦移動のためにすべり可能に
取付けたナイフブロック134を含む。ナイフブロック
134は、ステープルカートリッジ60の中央縦溝穴6
2内に前方に延びるナイフ支持バー136を含む。傾斜
ナイフ刃138は、ナイフ支持バー136の前方端部に
位置する斜角切削縁140を備える。ナイフ刃138の
斜角切削縁は、伸長あご部材22と24に関してある角
度において方向付けられ、ステープルカートリッジ60
の中央縦溝穴62にすべり可能に収容される。
様において、ナイフブロック134は、推進ブロック1
12をナイフブロックに関して滑動させるために、ステ
ープル推進バー124をすべり可能に収容する貫通する
一対の縦溝穴135(図20)を含む。従って、推進ブ
ロック112が作動器ノブ114によってステープルカ
ートリッジ60の方に進められる時、ステープル推進バ
ー124は、推進ブロックが移動してナイフブロックと
係合するまで、定置しているナイフブロック134を通
って滑動する。ナイフブロック134が推進ブロック1
12によって係合された後、ナイフブロックと推進ブロ
ックは、ステープルカートリッジ60の方に同時に前進
する。図18に示された如く、ナイフ刃138は、ステ
ープル推進バー124とともにステープルカートリッジ
60を通って進められ、あご部材の間で把持した組織に
おいてステープル61を形成し、ステープル行の間で組
織を切断する。その後、作動器ノブ114が引込められ
る時、推進ブロック112は、初期的に、定置している
ナイフブロック134を通って後方にステープル推進バ
ー124を滑動させる。各ステープル推進バー124
は、ステープル推進バー124が所定距離だけ回収され
た後、ナイフブロック134と係合するように移動する
オフセット部分142を含む。ステープル推進バー12
4のオフセット部分がナイフブロック134に係合する
と、推進ブロック112とナイフブロック134は、推
進バー124とナイフ刃138を開始位置に戻すために
作動器ノブ14によって同時に引込められる。
は、ステープル61の形成中、ステープルカートリッジ
60とアンビル40を付勢するために、あご部材に締付
け力を加えるためのあご締付け手段を備える。あご締付
け手段は、ステープル61が形成される時、ステープル
カートリッジ60とアンビル40に及ぼされた力を阻止
するために、ラッチ機構から遠い位置においてあご部材
を付勢するための手段を含む。好ましい実施態様におい
て、カム手段が、あご部材の一方において取付けられ、
他方のあご部材と係合可能であり、ステープルカートリ
ッジ60とアンビル40を付勢するために遠い位置に該
あご部材を移動させる。好ましくは、カム部材は、ラッ
チ機構から遠い位置においてあご部材の一方において旋
回可能に取付けられる。カム部材は、あご部材の遠隔端
部を移動させるために、第1非作動位置から第2動作位
置に旋回可能である。カム部材は、推進ブロックが前進
される時、その作動位置に移動し、そして推進ブロック
が引込められる時その非作動位置に戻るために、推進バ
ー及びナイフ刃組立品110の推進ブロック112によ
って作動可能である。
様において、一般に150のカム機構が、図4に示され
た如く下側あご部材24の後方端部に隣接して位置す
る。カム機構150は、下側あご部材24の直立側方フ
ランジ54の間に横ピボットピンにおいて旋回可能に取
付けたカム部材152を含む。カム部材152は、カム
152をその第1非作動位置(図12)にした上側あご
部材22の頂壁31に係合するための第1下側カム表面
156と、カム152をその第2作動位置(図13)に
配した上側あご部材22の頂壁31に係合するための第
2高カム表面158とを含む。第1カム表面156は、
上側及び下側あご部材をその非作動位置におけるカム1
52と実質的に平行に維持するように配置される。第2
カム表面158は、カム152が非作動位置から作動位
置に旋回する時、約0.125インチ(3.2mm)だ
け上側あご部材22の後方端部を上昇させるように配置
される。加えて、上側あご部材22は、カム部材152
が非作動位置から作動位置に移動される時、上側あご部
材22の後部を下側あご部材24から上方に曲げさせる
ために十分にたわみ性である。
カムを大前指162と小後指164に分割する放射状切
欠き160を含む。前方カム指162は、平坦な後向き
表面165を含み、そして後方カム指164は、傾斜し
た前向き表面166を含む。カム152をその非作動位
置におくと、前方カム指162と後方カム指164は、
下側あご部材24の底壁53に形成した伸長溝穴168
を通って下方に突出する。
2は、推進ブロックが進められる時、非作動位置から作
動位置に移動するために推進ブロック112によって作
動される。図11に示された如く、推進ブロック112
は、間隙172をその間に規定するために離間された一
対の後向き腕170を含む。腕170の後方端部は、間
隙172を横断するカム作動器ピン174によって連結
される。図4と図11を参照すると、カム部材152を
非作動位置に配して、前方カム指162は、推進ブロッ
ク112の腕170の間の間隙172を貫通するが、カ
ム作動器ピン174は、カム部材の前方指162と後方
指164の間の切欠き160において収容される。
第1非作動位置に配して、上側あご部材22の頂壁31
は、カム部材の第1カム表面156に載上する。カム部
材152を非作動位置にして、上側あご部材22の頂壁
31は、下側あご部材24の底壁にほぼ平行である。加
えて、推進ブロック112は、ナイフブロック134か
ら後方に離間した開始位置に位置する。推進ブロック1
12が、矢印182(図13)によって指示された如く
進められる時、カム作動器ピン174は、前方カム指1
62の後方表面165に係合し、矢印184によって指
示された如く、カム部材152を反時計回り方向におい
て回転させ、カム部材を第2作動位置に旋回させ、第2
カム表面158を上側あご部材22の頂壁31との係合
に移動させる。カム部材152を作動位置に旋回させる
と、上側あご部材22の頂壁31は、下側あご部材24
の底壁53から、矢印186によって指示された如く、
上方に曲げられる。カム部材は、あご部材の後部を曲げ
させる力を上側あご部材22と下側あご部材24に加え
る。離間した上側あご部材22と下側あご部材24の後
部の曲げの結果として、付加的な締付け力が、上側あご
部材22と下側あご部材24の前部に加えられ、あご部
材の間に把持した組織に対してアンビル40とステープ
ルカートリッジ60を締付ける。こうして、アンビル4
0とステープルカートリッジ60は、推進バー及びナイ
フ刃組立品110がステープル61を形成し組織を切断
するために進められる時、アンビルとステープルカート
リッジに及ぼされた力を阻止するように付勢される。
成後、推進ブロック112が引込められる時、カム作動
器ピン174は、カム部材152を時計回り方向に旋回
させるために後方カム指164の傾斜面166に係合す
る。カム作動器ピン174が傾斜面166を沿って切欠
き160へ移動する時、カム部材152は、時計回り方
向に旋回し、その第1カム表面156が上側あご部材2
2の頂壁31に係合した第1非作動位置(図12)に戻
る。結果として、カム152によって上側あご部材22
と下側あご部材24の後部に及ぼされた力は解放され、
そして上側あご部材22の頂壁31は、下側あご部材2
4の底壁53と実質的な平行関係に戻る。同様に、あご
部材22と24の前部に加えられた締付け力は、アンビ
ル40とステープルカートリッジ60の留めを緩めるた
めに解放される。
様は、ステープリング器具のステープルカートリッジ6
0とアンビル40の間に所定の間隙を維持するためのあ
ご部材の一方に取付けたスペーサ手段を含む。図4と図
6を参照すると、このスペーサ手段は、ステープルカー
トリッジ60の遠位端部に隣接して取付けたスペーサピ
ン190として具現される。スペーサピン190は、ス
テープルカートリッジ60を通って下側あご部材24の
底壁53から垂直上向きに配設され、所定の距離だけス
テープルカートリッジの頂部から上方に突出する。図5
に示された如く、アンビル40の一つのフランジ38
は、スペーサピン190に係合するためにその遠位端部
に隣接してフランジ区分192を含む。ステープリング
器具が操作のために組み立てられる(図4)と、スペー
サピン190は、アンビル40とステープルカートリッ
ジ60の間に所定の間隙を維持するためにフランジ区分
192に係合する。
ステープルされ切断される組織は、初期的に、あご部材
22と24の間に置き、あご部材によって締付けなけれ
ばならない。こうして、取手26と28は、そのアンラ
ッチ位置(図2)へのラッチ腕92の下方旋回移動によ
り、アンラッチされる。結果として、ラッチピン36の
対向端部は、ラッチ腕92のフック部材96に形成した
溝穴98から外される。その後、上側及び下側あご部材
22と24は、下側あご部材の側方フランジ54におい
て形成した溝穴56からラッチピン36を外すことによ
り分離される。
あご部材22と24に置かれる。例えば、図17に示さ
れた如く、一片の管状腸組織は、各あご部材の前部にす
べり込ませる。組織があご部材に置かれた後、ステープ
リング器具20は再組立てされる。再組立ては、ラッチ
ピン36を下側あご部材24の直立側方フランジ54に
形成した垂直溝穴56と整列させることにより達成され
る。その後、下側あご部材24の側方フランジ54は、
上側取手26の内側に位置付けられ、上側あご部材22
の側壁30にわたるが、ラッチピン36の対向端部は、
垂直溝穴56に挿入される。最後に、ラッチ腕92は、
そのカバー100を下側取手28の底部と同一平面にし
て、そのラッチ位置(図3)に上方に旋回される。結果
として、フック部材92は、ラッチピン36上を旋回さ
れ、そして溝穴98は、ラッチピンの対向端部を収容す
る。こうして、上側あご部材22と下側あご部材24
は、アンビル40とステープルカートリッジ60に隣接
した中間位置においてラッチされる。加えて、スペーサ
ピン190は、アンビル40とステープルカートリッジ
60の間に所定の間隙を維持するために、身体組織を通
ってアンビル40のフランジ区分192に係合する。
テープリング器具20は、推進バー及びナイフ刃組立品
110を作動させるために、作動器ノブ114を前進さ
せることにより点弧される。初期的に、カム機構150
の作動において、推進ブロック112と推進バー124
(図4)は、ナイフブロック134が定置している間、
進められる。推進ブロック112と推進バー124のみ
が、カム部材152を作動させるために進められるため
に、ステープリング器具20を動作させるために必要と
される初期力は最小にされる。
の初期前進中、推進バー124は、ナイフブロック13
4を通って滑動し、そして推進バーのくさび形状先端1
28は、ステープルカートリッジ60の溝穴66を通っ
て前進し始める。推進ブロック112がナイフブロック
134の方に前進する時、そのカム作動器ピン174
は、図13の矢印184によって指示された如く、カム
152を反時計回りに旋回させるために前方カム指16
2の後面165に係合し、カム部材の第2カム表面15
8を上側あご部材22の頂壁31との係合に移動させ
る。カム部材152は、離間したあご部材の後方部分を
曲げさせる力を上側あご部材22と下側あご部材24に
加える。結果として、上側あご部材222の頂壁31の
後端は、下側あご部材24の底壁53の後端に関して約
0.125インチ(3.2mm)だけ上方に曲げられ
る。あご部材22と24の後端の曲げは、あご部材の前
部における付加的な締付け力を生じさせ、あご部材の間
に把持した組織に対してアンビル40とステープルカー
トリッジ60を締付ける。これらの付加的な締付け力
は、アンビル40とステープルカートリッジ60に及ぼ
された力を阻止する傾向があり、組織は切断され、ステ
ープル61がアンビル40に対して形成され、アンビル
40とステープルカートリッジ60の間に所望の間隔を
維持し、実質的に一様の高さである形成ステープル61
を生成する。
動された後、推進ブロック112は、続いて、ステープ
ルカートリッジ60の方へのナイフブロック134の縦
移動を開始するためにナイフブロック134に係合す
る。好ましくは、推進ブロック112とナイフブロック
134の間の初期間隔は、カム部材152がその作動位
置に到達するわずかに前に、推進ブロック112がナイ
フブロック134に係合する如く配置される。代替的
に、推進ブロック112とナイフブロック134の間の
初期間隔は、作動位置へのカム部材152の移動が完了
した後、推進ブロック112が初期的にナイフブロック
134に係合する如く配置される。推進ブロック112
がナイフブロック134に係合する時、アンビル40と
ステープルカートリッジ60の中央縦溝穴42と62に
沿ったナイフ刃138の前進が、それぞれ開始される。
その後、ステープル推進バー124とナイフ刃138
は、アンビル40とステープルカートリッジ60の間に
把持した組織をステープルし切断するために同時に進め
られる。
ープル推進バー124は、ステープルカートリッジ60
において設けた溝穴66に沿って縦に移動される。ステ
ープル推進バー124の2つのくさび状カム表面130
は、ステープルドライバー65の傾斜面との係合に溝穴
66を通って移動し、カートリッジ60からステープル
61を順次に駆動し、アンビルフランジ38に対してB
形状構成にステープル61を形成する。カム表面130
は、中央縦溝穴62の対向側に位置するステープルドラ
イバー65を同時に作動させるために、推進ブロック1
12から同一距離に位置する。同時に、ナイフブロック
134は、あご部材の間に把持した組織を切断するため
に、アンビル40の中央縦溝穴42とステープルカート
リッジ60の中央縦溝穴62を通ってナイフ刃138を
移動させるために進められる。カム機構150を介して
上側あご部材22と下側あご部材24の前部に加えられ
た付加的な締付け力は、ステープル61が形成される
時、アンビル40とステープルカートリッジ60に及ぼ
された力を阻止する傾向がある。
おけるステープルのすべてを形成するために十分に進め
られた後、推進ブロックは、作動器ノブ114の引込み
によりその開始位置の方に引込められる。ステープル推
進バー124は、定置しているナイフブロック134を
通って滑動するために、初期的に、推進ブロック112
のみが、ステープルカートリッジ60から後方に移動す
る。ステープル推進バー124のオフセット部分142
がナイフブロック134の前部に係合する時、ナイフブ
ロックは、推進ブロック112とともにステープルカー
トリッジ60から後方に移動される。結果として、ステ
ープル推進バー124とナイフ刃138は、ステープル
カートリッジ60とアンビル40から同時に引込められ
る。
戻る時、カム作動器ピン174は、後方カム指164の
傾斜面166に係合し、その非作動位置の方に時計回り
方向にカム部材152を旋回させる。カム作動器ピン1
74は、カム部材152をその非作動位置に戻すため
に、カム指162と164の間の溝穴160に傾斜面1
66に沿って移動する。結果として、カム部材152の
第2カム表面158は、上側あご部材22の頂壁から外
され、そして上側あご部材22の頂壁31の後端は、第
1カム表面156との係合に下方に移動する。同時に、
前方カム指162は、推進ブロック112における指1
70の間の間隙172に下方に旋回し、そして両方のカ
ム指162と164は、下側あご部材24の底壁53に
おいて形成した溝穴168に下方に旋回する。その後、
カム部材152をその非作動位置にして、ラッチ腕92
は、図2に示された如く下方に旋回され、上側あご部材
22と下側あご部材24を分解させる。この点におい
て、切断されステープルされた組織は、あご部材から除
去される。
と図25に示される。図22と図23に示された如く、
アンビル承口を整列させる潜在的な代替案の一つが、こ
こで記載される。図22に示された如く、アンビル承口
200は、ステープルの中心線に沿ってそれぞれのステ
ープルに対して調整されている。今、アンビル承口20
0は、ステープルの中心線に対して角度αにおいてわず
かに歪曲される。例えば、図22aのステープル201
において、これらのアンビル承口200は、ステープル
の脚部202a、202bの各々に係合する。従って、
ステープルの端を曲げる時、ステープル201の各それ
ぞれの脚部202bは、脚部202aに関して歪曲さ
れ、その結果、ステープル脚部202a、202bの端
が曲げられる時、それらは、非常に高い確実度により互
いに接触しない。対照的に、場合により、図21に示さ
れた如くステープル脚部202a、202bが、ステー
プルを完全に形成することが困難である如く互いに接触
することも可能である。
ンビル250の基部は、もはや平坦ではなく、ステープ
ルの脚部202a、202bが、端を曲げることにより
互いに接触しないことをさらに保証するために湾曲され
る。さらに別の潜在的な実施態様が、図24、図24a
と図24b、並びに図25、図25cと図25dに示さ
れる。図24aと図24bの見取図に示された如く、ス
テープル承口260の底部261は、互いにそれぞれ角
度θにおいて傾けられる。このようにして、ステープル
201が形成される時、ステープルの脚部202a、2
02bは、対向ステープル脚部の平面の外にわずかに曲
げられるために、相接を失う。もちろん、図24cと図
24dに示された如く、角度βは、図23に記載された
角度θよりもずっと浅くされる。重要なことは、承口2
60の基部261が、承口260の軸Lにもはや垂直で
はなく、かなり角度を付けられ、即ち、「傾斜」され、
その結果、ステープルの脚部202a、202bは、端
の曲げにより互いに接触しないことである。
は、より正確に形成し端を曲げることができることが認
められる。このように、それは、図1〜図21の実施態
様において開示されたステープラについての改良であ
る。もちろん、このステープルの実施態様は、円形ステ
ープラ等の他のステープラ(前述)で使用できる。この
ように、本発明は、あらゆる種類のステープラに対して
使用され、添付のクレイムにより記載される。
りである。
少なくとも一つのアンビルを含む外科用ステープラであ
り、該外科用ステープルは、冠部に装着した一対の脚部
を含み、アンビルは、該ステープルの脚部の端を曲げる
承口を有し、そしてステープラは、該承口へ該ステープ
ル脚部を押しやるドライバーを有する外科用ステープラ
において、該承口の各々が該承口の各々の中心間に引か
れた中心線に対して角度を形成する如く該承口の整列を
ずらせることを含む外科用ステープラ。
ルの脚部に関して直線である上記1に記載のステープ
ラ。
に関して湾曲される上記1に記載の改良。
少なくとも一つのアンビルを含む外科用ステープラであ
り、該外科用ステープルは、冠部に装着した一対の脚部
を含み、アンビルは、該ステープルの脚部の端を曲げる
承口を有し、そしてステープラは、該承口へ該ステープ
ル脚部を押しやるドライバーを有する外科用ステープラ
において、該アンビル承口が、基部によって連結した一
対の壁で形成され、該基部は、該壁のいずれかに垂直で
ない角度において形成されることである外科用ステープ
ラ。
グ器具の全体斜視図である。
ートリッジ保持あご部材から取り外した、部分的に分解
した吻合ステープリング器具を示す側面図である。
を示す側面図である。
ためのカム機構を示す、吻合ステープリング器具の部分
的に断面の側面図である。
材の底面図である。
ッジ保持あご部材の頂面図である。
フ刃組立品の拡大斜視図である。
フ刃組立品の構成要素である推進ブロックと作動器ノブ
の拡大斜視図である。
テープリング器具の後部の部分的に断面の拡大正面図で
ある。
ープリング器具の後部の部分的に断面の拡大正面図であ
る。
リッジの拡大側面図である。
リッジの拡大頂面図である。
リッジの拡大底面図である。
ープルカートリッジ保持あご部材の拡大部分切欠図であ
る。
アンビル及びステープルカートリッジ保持あご部材の拡
大部分切欠図である。
ープリング器具の拡大垂直断面図である。
ープリング器具の拡大垂直断面図である。
ートリッジの部分の拡大断面図である。
ビル承口の図である。
ある。
である。
である。
Claims (2)
- 【請求項1】 外科用ステープルの端を曲げるための少
なくとも一つのアンビルを含む外科用ステープラであ
り、該外科用ステープルは、冠部に装着した一対の脚部
を含み、アンビルは、該ステープルの脚部の端を曲げる
承口を有し、そしてステープラは、該承口へ該ステープ
ル脚部を押しやるドライバーを有する外科用ステープラ
において、該承口の各々が該承口の各々の中心間に引か
れた中心線に対して角度を形成する如く該承口の整列を
ずらせることを含む外科用ステープラ。 - 【請求項2】 外科用ステープルの端を曲げるための少
なくとも一つのアンビルを含む外科用ステープラであ
り、該外科用ステープルは、冠部に装着した一対の脚部
を含み、アンビルは、該ステープルの脚部の端を曲げる
承口を有し、そしてステープラは、該承口へ該ステープ
ル脚部を押しやるドライバーを有する外科用ステープラ
において、該アンビル承口が、基部によって連結した一
対の壁で形成され、該基部は、該壁のいずれかに垂直で
ない角度において形成されることである外科用ステープ
ラ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US20184594A | 1994-02-25 | 1994-02-25 | |
US201845 | 1994-02-25 |
Publications (1)
Publication Number | Publication Date |
---|---|
JPH0833642A true JPH0833642A (ja) | 1996-02-06 |
Family
ID=22747541
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP7058161A Pending JPH0833642A (ja) | 1994-02-25 | 1995-02-22 | 外科用ステープラのための改良アンビル承口 |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP0669104A1 (ja) |
JP (1) | JPH0833642A (ja) |
AU (1) | AU1347495A (ja) |
CA (1) | CA2143247A1 (ja) |
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Also Published As
Publication number | Publication date |
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AU1347495A (en) | 1995-09-07 |
EP0669104A1 (en) | 1995-08-30 |
CA2143247A1 (en) | 1995-08-26 |
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