ES2247490T3 - Grapa quirurgica mejorada. - Google Patents
Grapa quirurgica mejorada.Info
- Publication number
- ES2247490T3 ES2247490T3 ES03253358T ES03253358T ES2247490T3 ES 2247490 T3 ES2247490 T3 ES 2247490T3 ES 03253358 T ES03253358 T ES 03253358T ES 03253358 T ES03253358 T ES 03253358T ES 2247490 T3 ES2247490 T3 ES 2247490T3
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- clip
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
-
- 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
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Molecular Biology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Materials For Medical Uses (AREA)
- Polymers With Sulfur, Phosphorus Or Metals In The Main Chain (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
Un sujetador médico (2) que tiene una primera forma no desplegada para su carga en una grapadora, y una segunda forma desplegada para la conexión de tejido entre sí, comprendiendo dicho sujetador: a. una corona (4) que tiene dos extremos (6, 8) y un eje longitudinal (9) que se extiende entre ambos, una primera y una segunda patas (10, 20) sujetas cada una a cada extremo (6, 8) de dicha corona (4), en el que dichas patas (10, 20) se extienden desde dicha corona (4) en una dirección sustancialmente perpendicular a dicho eje longitudinal (9) de la citada corona (4) cuando el citado sujetador (2) está en la citada primera forma, y b. en el que dichas patas (10, 20) comprenden una primera y una segunda capas (30, 40) de material, unidas entre sí; que se caracteriza porque dicha primera capa (30) de material comprende una aleación súper-elástica tratada de manera que tiene un temperatura Af por debajo de 37 ºC y una configuración relajada sustancialmente en dicha segunda forma, comprendiendo dicha segunda capa (40) de material un material lineal elástico que tiene una configuración relajada sustancialmente en la citada primera forma, y que tiene rigidez suficiente para mantener la citada primera capa (30) en la citada primera forma con anterioridad a que el citado sujetador (2) sea desplegado.
Description
Grapa quirúrgica mejorada.
La presente invención tiene aplicación en
instrumentación endoscópica convencional y quirúrgica abierta, así
como aplicación en cirugía asistida por robótica. La presente
invención tiene una relación incluso mayor con las grapas y las
grapadoras quirúrgicas.
En los últimos años, la cirugía ha avanzado
considerablemente mediante la ejecución de procedimientos
quirúrgicos laparoscópicos y endoscópicos tales como
colecistectomías, gastrostomías, apendectomías, y reparación de
hernias. Estos procedimientos se realizan a través de un conjunto de
trócar, el cual es un instrumento quirúrgico utilizado para punzar
una cavidad corporal. El trócar contiene una punta obturadora
aguzada y un tubo de trócar o cánula. La cánula de trócar se inserta
en la piel para acceder a la cavidad corporal, utilizando la punta
obturadora para penetrar la piel. Tras la penetración, el obturador
se retira y la cánula de trócar permanece en el cuerpo. Es a través
de esta cánula que se colocan los instrumentos quirúrgicos.
Específicamente, es a través de esta cánula de trócar que se colocan
los instrumentos de grapado quirúrgico con los mecanismos de corte.
Un trócar de este tipo es el trócar Endopath® fabricado por ETHICON
ENDOSURGERY, Cincinnati, Ohio.
La aplicación de instrumentos endoscópicos de
sutura y grapado quirúrgicos, ha sido prevista en tales
procedimientos quirúrgicos. Un instrumento endoscópico de ese tipo,
mencionado con frecuencia como endo-cortador, está
capacitado para separar tejido y proporcionar hemostasis a lo largo
de ambos lados del corte. Un ejemplo de
endo-cortador puede ser encontrado en la Patente
U.S. núm. 5.673.840.
En el caso de un endo-cortador de
ese tipo, el tejido se comprime entre una mordaza inferior y un
yunque. La mordaza inferior sujeta un cartucho que sujeta
accionadores diminutos que albergan grapas en forma de U. Una vez
que el tejido ha sido comprimido, el movimiento axial de las cuñas
de disparo fuerza a los actuadores y grapas radialmente hacia el
yunque. Este movimiento provoca que las grapas perforen el tejido
comprimido, y golpean bolsas curvas formadas en la cara del yunque.
Cuando las patas de las grapas golpean las bolsas del yunque, éstas
se encorvan desde la columna de carga, y se tuercen hacia el
interior de una manera que es similar, en lo que a concepto se
refiere, a una grapadora común de oficina. La geometría de bolsa de
yunque provoca que las mismas se deformen hacia el interior,
configurándose en forma de B, según las patas de las grapas son
deformadas permanentemente hacia atrás sobre sí mismas. Con
frecuencia, son conformadas simultáneamente dos filas triples de
grapas, con una cuchilla que sigue justamente a continuación de la
operación de conformación para separar el tejido entre las dos filas
(líneas) triples de grapas. Existe una cantidad de problemas
asociados a las fuerzas requeridas para deformar las grapas y lograr
la forma que la grapa deformada adopta bajo determinadas
circunstancias. Las elevadas fuerzas requieren materiales y técnicas
de fabricación caros, debido a que la mordaza y el yunque necesitan
ser considerablemente fuertes y rígidos. Además, estas fuerzas
elevadas requieren altas fuerzas de cuña de disparo. Estas fuerzas
deben ser generadas en toda la longitud de la línea de grapa. La
cantidad de energía total resultante limita la longitud de las
líneas de grapas que pueden ser formadas por una persona que utilice
un movimiento de apriete con una sola mano. Muchos médicos
encuentran difícil de disparar un endo-cortador.
Además, resulta difícil utilizar un único tamaño
de grapa que pueda proporcionar hemostasis sobre una gama de
espesores de tejido. Con grapas metálicas convencionales, las patas
de la grapa tienden simplemente a ceñirse a parte del recorrido de
vuelta desde los extremos distales. Esta porción distal se mantiene
principalmente recta. Como resultado, cuando las grapas se deforman
de manera más extensiva para tejido muy delgado, las porciones
rectas de las patas de la grapa pasan más allá de la base plana de
la grapa, y los extremos puntiagudos se elevan sobresaliendo por
fuera del tejido, con lo que pueden atrapar y lacerar tejido. Si el
tejido es muy grueso y solamente se forman las porciones distales de
las patas de la grapa, las patas de la grapa no se curvarán hacia
atrás sobre sí mismas para formar la geometría a modo de gancho
requerida para mantener el tejido en su lugar.
El documento WO 96/16603 constituye la base de la
parte pre-caracterizadora de la reivindicación 1
anexa.
De acuerdo con la presente invención, se
proporciona un sujetador quirúrgico según se define en la
reivindicación 1 y una grapa quirúrgica, según la reivindicación 2,
que posee una primera forma no desplegada para su carga en una
grapadora, y una segunda forma desplegada para la conexión de tejido
entre sí. El sujetador de grapa posee una corona y una primera y una
segunda patas, cada una de éstas unida a cada uno de los extremos de
la corona. Las patas se extienden desde la corona en una dirección
sustancialmente perpendicular al eje longitudinal de la corona
cuando la grapa está en su primera forma. Las patas comprenden una
primera y una segunda capas de material unidas entre sí. La primera
capa de material consiste en una aleación
súper-elástica que tiene una configuración relajada
sustancialmente en la segunda forma de la grapa. La segunda capa de
material consiste en un material elástico lineal que tiene una
configuración relajada sustancialmente en la primera forma de la
grapa. La segunda capa de material tiene rigidez suficiente para
mantener la primera capa en la primera forma con anterioridad a que
la grapa sea desplegada.
Las características novedosas de la invención se
exponen con minuciosidad en las reivindicaciones adjuntas. La
invención en sí misma, sin embargo, junto con otros objetos y
ventajas de la misma, puede ser mejor comprendida mediante
referencia a la descripción que sigue, tomada junto con los dibujos
que se acompañan, en los que:
La Figura 1 es una vista lateral de una grapadora
quirúrgica, que puede ser utilizada con la presente invención;
la Figura 2 es una vista en planta de una grapa
quirúrgica de acuerdo con la presente invención, y que muestra la
grapa en su forma no desplegada;
la Figura 3 es una vista en sección transversal
de la grapa mostrada en la Figura 1, tomada a lo largo de la línea
3-3, y
la Figura 4 es una vista en planta de la grapa
quirúrgica mostrada en la Figura 1, pero mostrando la grapa en su
forma desplegada.
Haciendo ahora referencia a los dibujos, en los
que números iguales indican los mismos elementos a través de las
vistas, se ha mostrado en la Figura 1 una grapadora quirúrgica, o
endo-cortador, 100, diseñada para ser utilizada con
la presente invención. La grapadora 100 es del tipo que se describe
en la Patente U.S. núm. 5.673.840. La grapadora 100, comprende una
porción de mango 110, medios giratorios 120, una porción de eje 130,
una porción de yunque 140, y un conjunto de cartucho 150. Un medio
de cuchilla (no representada), es deslizable por el interior del
conjunto de cartucho 150, para cortar el tejido. En la porción de
mango 110 existe un primer gatillo o de cierre 112 (también conocido
como gatillo de fijación), y un segundo gatillo o de disparo 114. El
gatillo de fijación 112 provoca que la porción de yunque 140 se
disponga en las proximidades del conjunto de cartucho 150. El
gatillo de disparo 114 provoca que las grapas sean expelidas desde
el cartucho y se conformen contra el yunque 142. El gatillo 114
provoca también que el medio de cuchilla se mueva a través del
conjunto de cartucho 150, con el fin de cortar el tejido.
Según apreciarán los expertos en la materia, la
grapa quirúrgica que se describe a continuación, tiene igual
aplicación para su uso en cortadores lineales abiertos, tales como
los descritos en la Patente U.S. núm. 4.520.817. Además, según se
utiliza aquí, el término "grapa" se refiere a cualquier tipo de
sujetadores quirúrgicos sustancialmente rígidos y deformables. En
consecuencia, como apreciarán los expertos en la materia, la grapa
que se describe a continuación tiene igual aplicación para su uso en
un aplicación de clip como en un dispositivo de ligadura, tal como
el que se describe en la Patente U.S. núm. 5.447.513.
Haciendo ahora referencia a la Figura 2, se ha
representado un sujetador quirúrgico, el cual, en esta realización,
se ha representado como grapa 2 realizada de acuerdo con la presente
invención, y diseñada para ser cargada en un cartucho del tipo
descrito más arriba como cartucho 150. Según se discutirá más
adelante, la grapa 2 tiene una primera forma no desplegada, y una
segunda forma desplegada. La Figura 2 representa la grapa 2 en su
primera forma, no desplegada. La grapa 2 posee una corona 4 que
tiene un primer y un segundo extremos 6 y 8, y un eje longitudinal 9
que se extiende entre ambos. La grapa 2 incluye también una primera
y una segunda patas 10 y 20. Las patas 10 y 20 tienen primeros
extremos 12 y 22, que están unidos al primer y segundo extremos 6 y
8 de la corona 4. Las patas 10 y 20 tienen también segundos extremos
14 y 24 que se extienden desde la corona 4 en dirección generalmente
perpendicular al eje longitudinal 9. Los segundos extremos 14 y 24
pueden incluir puntas aguzadas 16 y 18.
La construcción material de la grapa 2, puede ser
descrita con referencia a la Figura 3. Según se aprecia en el
dibujo, al menos las patas, si no lo está la grapa en su totalidad,
se han formado a partir de 2 capas co-extensivas de
material 30 y 40, unidas entre sí. Tal y como se discutirá con mayor
detalle en lo que sigue, la primera capa de material, o núcleo 30,
está hecha a partir de una aleación súper-elástica
que tiene una configuración relajada sustancialmente en la segunda
forma de la grapa. La segunda capa de material 40, o carcasa, está
hecha de un material lineal elástico que tiene una configuración
relajada sustancialmente en la primera forma de la grapa. La segunda
capa de material 40 tiene rigidez suficiente como para mantener la
primera capa en la primera forma con anterioridad a que la grapa sea
desplegada.
A los efectos de esta invención, la primera y la
segunda capas de material son intercambiables. Por ejemplo, la
primera capa interior 30, o núcleo, podría estar hecha de un
material lineal elástico, mientras que la segunda capa externa 40, o
carcasa, está construida a partir de un material
súper-elástico. Además, no es necesario que las
capas tengan secciones transversales circulares, sino que podrían
adoptar cualquier forma deseada. Además, no es necesario que la
sección transversal de la grapa tenga la configuración del núcleo/
carcasa. Las capas podrían estar yuxtapuestas y ser
co-extensivas cada una con la otra, o tener
cualquier otra configuración deseada.
La primera capa 30 de material se hace, con
preferencia, de una aleación súper-elástica o
seudo-elástica. Un tipo de material de ese tipo se
conoce habitualmente como Nitinol. La naturaleza de la
transformaciones súper-elásticas de aleaciones con
memoria de forma, se discuten en "Engineering Aspects of Shape
Memory Alloys, Aspectos Tecnológicos de Aleaciones con Memoria de
Forma", T W Duerig et al, página 370,
Butterworth-Heinemann (1990). Una característica
principal de las aleaciones con memoria de forma incluye un
incremento inicial de la tensión, aproximadamente lineal con el
esfuerzo. Este comportamiento es reversible, y corresponde con la
deformación elástica convencional. Los incrementos adicionales de la
tensión van acompañados de un pequeño, o ninguno, incremento del
esfuerzo, en una gama de tensión limitada al final del "plató de
carga". El esfuerzo de plató de carga está definido por el punto
de inflexión del gráfico esfuerzo/ tensión. Los incrementos
posteriores de tensión van acompañados por incrementos en el
esfuerzo. Con la descarga, existe una caída en el esfuerzo con
reducción de la tensión al principio del "plató de descarga",
evidenciada por la existencia de un punto de inflexión, a lo largo
de la cual cambia poco el esfuerzo con la reducción de la tensión.
Al final del plató de descarga, el esfuerzo se reduce con la
reducción de la tensión. El esfuerzo de plató de descarga está
definido también por el punto de inflexión del gráfico esfuerzo/
tensión. Cualquier tensión residual tras la descarga a esfuerzo
cero, constituye la disposición permanente de la muestra. Las
características de esta deformación, el plató de carga, el plató de
descarga, el módulo elástico, la longitud de plató, y la disposición
permanente (definida con respecto a la deformación total
específica), han sido establecidas, y están definidas, por ejemplo,
en "Engineering Aspects of Shape Memory Alloys, Aspectos
Tecnológicos de Aleaciones con Memoria de Forma", en la página
376.
Se pueden introducir propiedades
súper-elásticas no lineales en una aleación con
memoria de forma mediante un proceso que incluye trabajar en frío la
aleación, por ejemplo mediante un proceso que incluye prensado,
estampación o estiramiento. Las propiedades
súper-elásticas son empleadas por la grapa en su
cambio de configuración entre su forma primera o no desplegada/
restringida, y su forma segunda o desplegada/ relajada. Un
tratamiento apropiado puede incluir una combinación de trabajo en
frío (por ejemplo, mediante estampación, estiramiento o, en
particular, mediante expansión con mandril), y tratamiento con calor
a una temperatura que es menor que la temperatura de
recristalización de la aleación mientras la grapa está restringida
en su la configuración resultante del trabajo en frío. Se puede
utilizar una pluralidad de etapas de trabajo en frío y de
tratamiento con calor. La grapa puede ser deformada entonces hacia
su forma no desplegada, siendo la deformación recuperable,
sustancialmente de forma elástica. De esta manera, se pueden
impartir deformaciones de hasta una tensión del 8%, y ser
recuperadas de manera sustancialmente elástica. La aleación para la
primera capa 30, se fabrica con preferencia de tal manera que
presenta propiedades súper-elásticas a la
temperatura corporal.
Las aleaciones binarias preferidas de Nitinol o
Ni-Ti para la primera capa de material, tienen un
contenido de níquel de alrededor del 50 por ciento atómico (en lo
que sigue, en %), con preferencia al menos alrededor del 50,5 en %.
El contenido de níquel será normalmente menor del 54 en %, con
preferencia menor de alrededor del 52 en %. Según apreciarán los
expertos en la materia, la primera capa puede estar hecha de otras
aleaciones a base de Ni-Ti, incluyendo aleaciones
con adiciones terciarias y cuaternarias. Ejemplos de elementos que
pueden ser incorporados en la aleación, incluyen Fe, Co, Cr, Al, Cu
y V. Los elementos añadidos pueden estar presentes en cantidades de
hasta alrededor de un 10 en %, con preferencia hasta alrededor de un
5 en %. Con preferencia, la temperatura de acabado austenítica (Af)
está por debajo de la temperatura corporal, y más preferiblemente es
de alrededor de 0ºC.
La segunda capa de material 40 está hecha
preferiblemente de un material lineal elástico, tal como hierro,
Nitinol no súper-elástico, acero inoxidable o
titanio. La segunda capa podría hacerse a partir de un material que
pudiera impartir cualidades radioopacas a la grapa, de modo que
pudiera ser vista mejor bajo rayos X. El límite elástico de la
segunda capa de material se establece de modo que sea moderadamente
más alto que la resistencia de recuperación de la primera capa de
material.
A efectos de ejemplo, se va a describir ahora la
fabricación de la grapa, en la que la segunda capa 40 comprende
hierro. La grapa puede ser fabricada inicialmente mediante
co-estiramiento de un tubo de alambre de hierro
alrededor de un alambre de Nitinol, con lo que se tiene un alambre
que presenta la sección transversal mostrada en la Figura 3. Es
decir, el alambre puede formarse haciendo deslizar una longitud de
alambre de Nitinol por el interior de una longitud de tubo de
hierro, y estirando a continuación los dos conjuntamente, hasta que
se alcance el diámetro de alambre deseado. El diámetro del núcleo de
Nitinol, el espesor de pared de la cubierta de hierro, y el nivel de
dureza de trabajo de la cubierta, pueden ser variados con el fin de
crear grapas con grados variables de sus propiedades deformadas.
El alambre puede ser cortado a continuación en
segmentos longitudinales de tamaño de grapa deseado. A continuación,
el segmento se enfría de modo que el Nitinol sea sustancialmente
martensítico, y a continuación el segmento se deforma según su forma
segunda/ desplegada deseada, mostrada en la Figura 4. El segmento se
trata a continuación con calor para establecer la forma del Nitinol
y suavizar parcialmente el esfuerzo del Titanio. Una vez que el
Nitinol del alambre ha sido puesto en forma, la grapa podría ser
enderezada hasta la adoptar la geometría que se muestra en la Figura
2, para formar la grapa 2, la cual será cargada a continuación en, y
utilizada con, grapadoras quirúrgicas convencionales.
La grapa 2 combina materiales de memoria de forma
y lineales elásticos, de tal modo que la grapa tiene algunas de las
propiedades de los materiales con memoria de forma y algunas de las
propiedades de los materiales lineales-elásticos.
Cuando se despliega la grapa, tal como proyectándola desde un
cartucho sobre un yunque, la suma de los esfuerzos asociados y de
los esfuerzos de recuperación de memoria de forma generados
internamente, exceden el límite elástico del material
lineal-elástico, de tal modo que la grapa se
deformará. Cuando se aplican cargas de tal modo que ayudan a la
conformación del material, los esfuerzos de recuperación y la carga
externa que se requieren para provocar la deformación, serán menores
que si las fuerzas se aplican a la porción
lineal-elástica de la grapa sola.
Según se despliega la grapa, esta grapa empezará
a deformarse y adoptará la forma de "B" deseada con cargas
mucho más bajas que una grapa convencional. Esto significa que
incluso en fases tempranas de formación de la grapa, las puntas de
la grapa adoptarán forma similar a la de un gancho, y eventualmente
se doblarán hacia atrás sobre sí mismas como se muestra en la Figura
4. Por el contrario, una grapa convencional se encorvaría
inicialmente en posición más próxima a la mitad de la grapa, y la
porción distal mayor de la pata de la grapa podría permanecer recta
e incluso no doblar. Como resultado, cuando las grapas se deforman
de manera más extensiva para tejido delgado, las porciones rectas de
las patas de la grapa pasan más allá de la base plana de la grapa, y
las puntas aguzadas se elevan sobresaliendo del tejido en el que se
han fijado, y laceran el tejido. Si el tejido es muy grueso y
solamente se forman las porciones distales de las patas de la grapa,
esas patas de la grapa no pueden curvarse sobre sí mismas para
formar la geometría a modo de gancho requerida para sujetar el
tejido en su lugar. La grapa mencionada anteriormente y su geometría
asociada, reducen esos inconvenientes.
Las fuerzas de conformación radial se mantendrán
más bajas para la grapa descrita en lo que antecede durante todo el
proceso de conformación, dado que las grapas fueron formadas
originalmente y puestas en forma con una altura conformada
ligeramente menor de la que la grapadora podría golpearlas para
conformarlas, incluso en tejido delgado. Esta reducción fundamental
de las fuerzas de formación de grapa, podrían tener un efecto de
rizado en el instrumento debido a que la tendencia a forzar el
yunque y el canal de cartucho a la separación, se reduciría. Se
podrían utilizar componentes más pequeños, más ligeros, para una
combinación dada de líneas de grapas y de longitud de línea de
grapa. Además, resultaría factible diseñar grapadoras con mordaza en
voladizo (la configuración más común), con longitudes de línea de
grapa más largas que las actualmente posibles, sin hacer los
componentes indeseablemente grandes y voluminosos.
Las propiedades de la grapa mencionada
anteriormente, podrían provocar que el fabricante incremente el
número de grapas, y en consecuencia, la longitud de la línea de
grapas que podrían ser conformadas por una persona utilizando un
movimiento de apriete con una sola mano. Esto significa que el
mecanismo de disparo con una mano, de carrera simple, popular y
económico en grapadoras más pequeñas, podría ser utilizado en
grapadoras con líneas de grapa más largas. Esto proporcionaría una
ventaja distinta sobre el coste y la complejidad de las grapadoras
que requieren múltiples actuaciones para formar todas las
grapadoras, o que se basan en diseños motorizados que privan al
cirujano de una realimentación táctil durante su uso.
Aunque aquí se han descrito y representado
realizaciones preferidas de la presente invención, resultará obvio
para los expertos en la que materia que tales realizaciones se
proporcionan únicamente a título de ejemplo. Numerosas variaciones,
cambios y sustituciones podrán ser introducidos ahora por los
expertos en la materia sin apartarse de la invención. Por ejemplo,
según resultará evidente para los expertos en la materia, las
descripciones aquí realizadas son igualmente aplicables a la cirugía
asistida con robótica. Adicionalmente, se comprenderá que cada
estructura descrita anteriormente tiene una función, y que tal
estructura puede ser mencionada como un medio para realizar esa
función. En consecuencia, se pretende que la invención esté limitada
solamente por el alcance de las reivindicaciones anexas.
Claims (8)
1. Un sujetador médico (2) que tiene una primera
forma no desplegada para su carga en una grapadora, y una segunda
forma desplegada para la conexión de tejido entre sí, comprendiendo
dicho sujetador:
a. una corona (4) que tiene dos extremos (6, 8) y
un eje longitudinal (9) que se extiende entre ambos, una primera y
una segunda patas (10, 20) sujetas cada una a cada extremo (6, 8) de
dicha corona (4), en el que dichas patas (10, 20) se extienden desde
dicha corona (4) en una dirección sustancialmente perpendicular a
dicho eje longitudinal (9) de la citada corona (4) cuando el citado
sujetador (2) está en la citada primera forma, y
b. en el que dichas patas (10, 20) comprenden una
primera y una segunda capas (30, 40) de material, unidas entre
sí;
que se caracteriza porque dicha primera
capa (30) de material comprende una aleación
súper-elástica tratada de manera que tiene un
temperatura Af por debajo de 37ºC y una configuración relajada
sustancialmente en dicha segunda forma, comprendiendo dicha segunda
capa (40) de material un material lineal elástico que tiene una
configuración relajada sustancialmente en la citada primera forma, y
que tiene rigidez suficiente para mantener la citada primera capa
(30) en la citada primera forma con anterioridad a que el citado
sujetador (2) sea desplegado.
2. Un sujetador médico (2) de acuerdo con la
reivindicación 1, el cual es una grapa quirúrgica (2), teniendo
dichas patas (10, 20) extremos distales (16, 18) que son
aguzados.
3. El sujetador o grapa (2) de la reivindicación
1 o la reivindicación 2, en el que dicha segunda capa (40) comprende
al menos uno de: hierro, aleación no súper-elástica
de níquel titanio, acero inoxidable y/o titanio.
4. El sujetador o grapa de una cualquiera de las
reivindicaciones 1 a 3, en el que dicha primera capa (30) comprende
una aleación de níquel titanio.
5. El sujetador o grapa (2) de una cualquiera de
las reivindicaciones anteriores, en el que dicha primera capa (30)
tiene una temperatura Af por debajo de 0ºC.
6. El sujetador o grapa (2) de una cualquiera de
las reivindicaciones 1 a 5, en el que dicha segunda capa (40) de
material está dispuesta concéntricamente alrededor de la citada
primera capa.
7. El sujetador o grapa (2) de la reivindicación
6, en el que dichas patas (10, 20) tienen una sección transversal
sustancialmente circular.
8. El sujetador o grapa (2) de una cualquiera de
las reivindicaciones 1 a 7, en el que dicha segunda forma tiene
sustancialmente una forma de "B".
Applications Claiming Priority (2)
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US10/158,118 US6638297B1 (en) | 2002-05-30 | 2002-05-30 | Surgical staple |
US158118 | 2002-05-30 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2247490T3 true ES2247490T3 (es) | 2006-03-01 |
Family
ID=29249912
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES03253358T Expired - Lifetime ES2247490T3 (es) | 2002-05-30 | 2003-05-29 | Grapa quirurgica mejorada. |
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US (1) | US6638297B1 (es) |
EP (1) | EP1366717B1 (es) |
JP (1) | JP4342838B2 (es) |
AT (1) | ATE300913T1 (es) |
AU (1) | AU2003204421B2 (es) |
CA (1) | CA2430397C (es) |
DE (1) | DE60301171T2 (es) |
ES (1) | ES2247490T3 (es) |
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CA2430397C (en) | 2011-07-12 |
EP1366717B1 (en) | 2005-08-03 |
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AU2003204421B2 (en) | 2007-08-30 |
JP2004249075A (ja) | 2004-09-09 |
JP4342838B2 (ja) | 2009-10-14 |
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