DE409569T1 - Verfahren und Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen. - Google Patents
Verfahren und Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen.Info
- Publication number
- DE409569T1 DE409569T1 DE90307811T DE90307811T DE409569T1 DE 409569 T1 DE409569 T1 DE 409569T1 DE 90307811 T DE90307811 T DE 90307811T DE 90307811 T DE90307811 T DE 90307811T DE 409569 T1 DE409569 T1 DE 409569T1
- Authority
- DE
- Germany
- Prior art keywords
- staple
- endoscopic
- jaws
- staples
- frame
- 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
- 238000000034 method Methods 0.000 title claims 3
- 230000005540 biological transmission Effects 0.000 claims 1
- 238000003780 insertion Methods 0.000 claims 1
- 230000037431 insertion Effects 0.000 claims 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Reproductive Health (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Instruments For Viewing The Inside Of Hollow Bodies (AREA)
- Endoscopes (AREA)
Claims (21)
1. Vorrichtung zum Anbringen chirurgischer Klammern an
Körpergeweben mit:
a)
einem Rahmen,
b) einer mit dem Rahmen verbundenen endoskopischen Vorrichtung allgemein länglicher Form, die sich
vo Rahmen aus distal erstreckt und ihrerseits aus folgenden Teilen besteht:
i) einer Vorrichtung zur Aufnahme mehrerer, chirurgischer Klammern;
ii) einer Vorrichtung zum wahlweisen Vorschieben der Klammern zum distalen Teil der endoskopischen
Vorrichtung, um sie in der Nähe des zu klammernden Körpergewebes anzuordnen; und
iii) einer Vorrichtung, die dann, wenndem die Klammer distal zu dem vorbestimmten Abschnitt der
endoskopischen Vorrichtung vorgeschoben worden ist, jede Klammer wenigstens teilweise soweit
verschließt, daß die Verschließung zu einem Ergreifen von Körpergeweben ausreicht.
2. Wegwerf-Vorrichtung zum Anbringen chirurgischer Klammern an Körpergeweben mit
-2- 04Ü9
a) einem Rahmen,
b) einem länglichen, endoskopischen Teil, der mit seinem proximalen Ende an dem Rahmen befestigt
ist und sich distal vom Rahmen wegerstreckt, wobei der endoskopische Teil aus folgenden
Einzelteilen besteht:
i) einer Vorrichtung zum Aufnehmen mehrerer chirurgischer Klammern,
ii) einem Paar von Backen, die am distalen Teil des endoskopischen Abschnittes
angeordnet und so ausgelegt sind, daß sie die Klammern aufnehmen,
iii) einer Vorrichtung zum Vorschieben der Klammern in distaler Richtung, um sie
innerhalb des Backenpaares in Stellung zu bringen, das nahe dem zu verklammernden
Körpergewebe in Stellung gebracht werden soll; und
iv) einer Vorrichtung zum wenigstens
teilweisen Verschließen der Backen um jede Klammer herum, um die Klammern wenigstens
teilweise um das Körpergewebe herum zu verschließen.
3. Wegwerf-Vorrichtung zum Anbringen chirurgischer Klammern an Körpergeweben mit
a) einem Rahmen, der so aufgebaut und bemessen ist, daß er mit der Hand ergriffen werden kann;
b) einem länglichen, endoskopischen Abschnitt, der mit seinem proximalen Ende am Rahmen befestigt
ist und sich von ihm aus in distaler Richtung erstreckt, wobei der endoskopische Abschnitt aus
folgenden Teilen besteht:
i) einer Vorrichtung zum Aufnehmen von
mehreren, chirurgischen Klammern, die dem distalen Teil des endoskopischen
Abschnittes in allgemein ausgerichteter Form gegenüberliegen,
ii) einer Backenanordnung, die am distalen Ende des endoskopischen Abschnittes
angeordnet und so ausgelegt ist, daß sie die Klammern nacheinander aufnehmen kann;
iii) einer Vorrichtung zum Vorschieben der
Klammern in distaler Richtung so, daß sie zwischen den Backen in Stellung gebracht
werden, um in die Nähe des zu klammernden Gewebes gebracht zu werden; und
iv) einer Vorrichtung zum wenigstens
teilweisen Schließen der Backen um jede Klammer herum, nachdem die Klammer
zwischen die Backen vorgeschoben worden ist, während gleichzeitig die Klammern-Vorschubvorrichtung zum distalen
Vorschieben der nächsten Klammer zurückgezogen wird.
4. Vorrichtung nach Anspruch 3, wobei der Rahmen ferner
einen Instrumentenkörper aufweist sowie einen an dem Instrumentenkörper befestigten Betätigungshandgriff.
5. Vorrichtung nach Anspruch 4, die ferner eine erste Übertragungsvorrichtung zum geradlinigen Übertragen
einer Bewegung von dem Betätigungshandgriff zu der Vorschubvorrichtung für die Klammern umfaßt.
6. Vorrichtung nach Anspruch 5, die ferner eine Vorrichtung zum Schließen der Backen umfaßt.
7. Vorrichtung nach Anspruch 6, die ferner eine Vorrichtung zu einer solchen Verriegelung des
Handgriffes umfaßt, daß nach einer Betätigung des Handgriffes, um die Backen zu schließen, der Handgriff
nicht mehr betätigt werden kann, wenn die Verriegelungsvorrichtung nicht vorher gelöst worden
ist.
8. Vorrichtung nach Anspruch 7, wobei der endoskopische Abschnitt unabhängig von dem Handgriff drehbar ist.
9. Vorrichtung nach Anspruch 8, die ferner eine Vorrichtung zum wahlweisen Verriegeln des
endoskopischen Abschnittes in einer vorbestimmten Winkelstellung relativ zum Handgriff umfaßt.
10. Vorrichtung nach Anspruch 3, wobei die Backenvorrichtung ein Paar von Backen umfaßt, die im
Abstand voneinander angeordnet und so ausgebildet und bemessen sind, daß zwischen ihnen eine chirurgische
Klammer aufgenommen werden kann, wobei die Backen auf die distale Bewegung einer Nockenvorrichtung von einer
proximalen zu einer distalen Stellung hin federnd aufeinander zu und voneinander wegbewegt werden können.
11. Vorrichtung nach Anspruch 10, wobei die Nockenvorrichtung einen Kanalteil umfaßt, der
verschiebbar an dem endoskopischen Abschnitt angebracht ist und der auf die Betätigung des
Handgriffes hin in Längsrichtung bewegbar ist, wobei das Kanalteil wenigstens zwei distale Nockenflächen
hat, um die Backen in ihre geschlossene Stellung zu beaufschlagen.
12. Vorrichtung nach Anspruch 3, wobei die Vorrichtung zum Aufnehmen der chirurgischen Klammern eine Schiene zum
Festhalten einer in Längsrichtung angeordneten Menge chirurgischer Klammern aufweist sowie eine Feder, die
proximal zu der Menge chirurigischer Klammern angeordnet ist, um diese in distaler Richtung zu
beaufschlagen.
13. Vorrichtung nach Anspruch 3, wobei die Vorrichtung zum Vorschieben der chirurgischen Klammern eine
Druckstange zum Vorschieben der am weitesten distal liegenden Klammer in den Bereich des Backenpaares,
wobei die Druckstange auf die Betätigung des Handgriffes hin in Längsrichtung verschiebbar ist
sowie eine Austrittsvorrichtung, die am distalen Ende der Klammernmenge angebracht ist, um die nächste
Klammer daran zu hindern, vor dem Vorschub in das Backenpaar verlagert zu werden.
14. Vorrichtung nach Anspruch 13, wobei die Austrittsvorrichtung wenigstens einen Vorsprung
umfaßt, der von der Klammernschiene aus vorsteht und sich in den Weg der Klammern hinein erstreckt, um eine
proximale Bewegung einer Klammer zu verhindern, nachdem diese in das Backenpaar vorgeschoben worden
ist.
— &ogr; —
15. Vorrichtung nach Anspruch 13, wobei ein erstes Drückrohr eine Bewegungsvorrichtung hat, um die
Druckstange drehbar an ihm zu befestigen.
16. Vorrichtung nach Anspruch 15, wobei die Befestigungsvorrichtung des Drückrohres einen im
allgemeinen kreisförmig geformten Vorsprung hat, der zur Aufnahme und zum Eingriff wenigstens eines
zusammenwirkenden Vorsprunges an der Druckstange bemessen ist.
17. Vorrichtung nach Anspruch 3, wobei die Backen-Vorrichtung ein am endoskopischen Abschnitt
befestigtes Backen-Leitteil aufweist sowie ein Paar von im distalen Abstand angeordneten Backen, die
federnd zwischen einer geschlossenen Stellung zum Schließen einer chirurgischen Klammer und einer
offenen Stellung zum Aufnehmen einer chirurgischen Klammer bewegbar sind, wobei die Nockenvorrichtung,
die von einem Kanalteil umfaßt wird, Nockenflächen hat, die von einer ersten Stellung, die zu den Backen
proximal liegt, in eine zweite, distale Stellung bewegbar ist, in der die Nockenflächen des Kanalteiles
die Backen in die geschlossene Stellung bewegen, wobei das Kanalteil an seinem proximalen Ende mit dem
Kanalrohr verbunden ist.
18. Vorrichtung nach Anspruch 3, wobei der endoskopische Abschnitt wegwerfbar und der Rahmen wiederverwendbar
ist.
19. Vorrichtung nach Anspruch 8, wobei der endoskopische Abschnitt zwischen mehreren, verrastbaren
Einstellungen verdrehbar ist.
Ü4Ü9
20. Vorrichtung nach Anspruch 3, wobei der endoskopische Abschnitt so ausgelegt ist, daß er eine gasförmige
Dichtung aufweist.
21. Verfahren zum endoskopischen Anbringen chirurgischer Klammern unter Verwendung einer Vorrichtung, die einen
Rahmen hat, der mit der Hand ergriffen werden kann sowie einen endoskopischen Abschnitt, der mit dem
Rahmen verbunden ist und in ausgewählte Stellungen relativ zum Rahmen verdrehbar ist, mit folgenden
Verfahrensschritten:
a) Einbringen der Klammern in den endoskopischen Abschnitt;
b) Vorschieben einer Klammer in distaler Richtung durch die Klammern-Vorschubvorrichtung, die
innerhalb des endoskopischen Abschnittes liegt zu einem Paar von Backen, die am distalen Ende
des endoskopsichen Abschnittes angeordnet sind;
c) Anordnen der Klammer in der Nähe des Körpergewebes, das verklammert werden soll;
d) Schließen der Backen um die Klammer herum, während die Klammer-Vorschubvorrichtung
gleichzeitig in eine Stellung proximal zur nächsten, vorzuschiebenden Klammer verlagert
wird; und
e) lösbares Verriegeln der
Klammer-Vorschubvorrichtung in dieser Stellung, bis sie zum Vorschub der nächsten Klammer
entriegelt wird.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US07/381,265 US5100420A (en) | 1989-07-18 | 1989-07-18 | Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures |
US07/530,652 US5084057A (en) | 1989-07-18 | 1990-05-30 | Apparatus and method for applying surgical clips in laparoscopic or endoscopic procedures |
Publications (1)
Publication Number | Publication Date |
---|---|
DE409569T1 true DE409569T1 (de) | 1993-11-25 |
Family
ID=27009311
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE90307811T Pending DE409569T1 (de) | 1989-07-18 | 1990-07-17 | Verfahren und Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen. |
DE69029823T Expired - Lifetime DE69029823T3 (de) | 1989-07-18 | 1990-07-17 | Verfahren und Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
DE69033727T Expired - Fee Related DE69033727T2 (de) | 1989-07-18 | 1990-07-17 | Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
DE69033507T Expired - Lifetime DE69033507T2 (de) | 1989-07-18 | 1990-07-17 | Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
Family Applications After (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE69029823T Expired - Lifetime DE69029823T3 (de) | 1989-07-18 | 1990-07-17 | Verfahren und Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
DE69033727T Expired - Fee Related DE69033727T2 (de) | 1989-07-18 | 1990-07-17 | Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
DE69033507T Expired - Lifetime DE69033507T2 (de) | 1989-07-18 | 1990-07-17 | Vorrichtung zum Anbringen von chirurgischen Klammern bei laparoskopischen oder endoskopischen Eingriffen |
Country Status (6)
Country | Link |
---|---|
US (1) | US5084057A (de) |
EP (3) | EP0738500B1 (de) |
JP (1) | JPH03136641A (de) |
AU (1) | AU632348B2 (de) |
CA (1) | CA2021362C (de) |
DE (4) | DE409569T1 (de) |
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- 1990-05-30 US US07/530,652 patent/US5084057A/en not_active Expired - Lifetime
- 1990-07-17 CA CA002021362A patent/CA2021362C/en not_active Expired - Lifetime
- 1990-07-17 EP EP96111515A patent/EP0738500B1/de not_active Expired - Lifetime
- 1990-07-17 DE DE90307811T patent/DE409569T1/de active Pending
- 1990-07-17 DE DE69029823T patent/DE69029823T3/de not_active Expired - Lifetime
- 1990-07-17 DE DE69033727T patent/DE69033727T2/de not_active Expired - Fee Related
- 1990-07-17 DE DE69033507T patent/DE69033507T2/de not_active Expired - Lifetime
- 1990-07-17 EP EP90307811A patent/EP0409569B2/de not_active Expired - Lifetime
- 1990-07-17 AU AU59126/90A patent/AU632348B2/en not_active Ceased
- 1990-07-17 EP EP96111375A patent/EP0738499B1/de not_active Expired - Lifetime
- 1990-07-18 JP JP2190356A patent/JPH03136641A/ja active Pending
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DE69033507D1 (de) | 2000-05-18 |
EP0738500A3 (de) | 1997-05-28 |
EP0409569B1 (de) | 1997-01-29 |
EP0409569B2 (de) | 2005-09-07 |
AU632348B2 (en) | 1992-12-24 |
EP0738500B1 (de) | 2001-04-18 |
JPH03136641A (ja) | 1991-06-11 |
DE69033727D1 (de) | 2001-05-23 |
EP0738499A3 (de) | 1997-06-04 |
CA2021362A1 (en) | 1991-01-19 |
DE69033507T2 (de) | 2000-09-14 |
EP0738499B1 (de) | 2000-04-12 |
AU5912690A (en) | 1991-01-24 |
DE69029823T3 (de) | 2006-05-18 |
DE69033727T2 (de) | 2001-09-13 |
EP0738500A2 (de) | 1996-10-23 |
US5084057A (en) | 1992-01-28 |
DE69029823T2 (de) | 1997-06-12 |
EP0738499A2 (de) | 1996-10-23 |
EP0409569A1 (de) | 1991-01-23 |
DE69029823D1 (de) | 1997-03-13 |
CA2021362C (en) | 1995-10-24 |
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