ES2388422T3 - Cartucho para grapadora y enclavador de canal - Google Patents

Cartucho para grapadora y enclavador de canal Download PDF

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ES2388422T3
ES2388422T3 ES10250889T ES10250889T ES2388422T3 ES 2388422 T3 ES2388422 T3 ES 2388422T3 ES 10250889 T ES10250889 T ES 10250889T ES 10250889 T ES10250889 T ES 10250889T ES 2388422 T3 ES2388422 T3 ES 2388422T3
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cartridge
channel
cartridge channel
surgical fasteners
assembly
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Paul Scirica
Lee Olson
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Covidien LP
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Tyco Healthcare Group LP
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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
    • A61B17/068—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
    • 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
    • A61B2017/07271—Stapler heads characterised by its cartridge

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  • 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

Un instrumento para aplicar fiadores quirúrgicos (10), que comprende: un yunque (34); un conjunto de cartucho (36) que define un eje longitudinal y que tiene un canal de cartucho (219), teniendo el canal de cartucho (219) un extremo distal con un saliente (225) al menos que se extiende transversalmente al eje longitudinal; y un cartucho de fiadores (220) situado dentro del canal de cartucho (219), teniendo el cartucho de fiadores (220) una pluralidad de fiadores quirúrgicos dentro de él y un rebajo (223) al menos para recibir el un saliente (225) al menos; y en el que: el un saliente (225) al menos comprende un par de salientes (225) que se extienden en sentidos en oposición; que se caracteriza porque el par de salientes (225) forma una extensión con forma de T del canal de cartucho (219); y porque el un rebajo (223) al menos forma un rebajo con forma de T que se corresponde con la extensión en forma de T del canal de cartucho (219).

Description

Cartucho para grapadora y enclavador de canal.
ANTECEDENTES
Campo técnico
Esta solicitud se refiere a un dispositivo de grapadora quirúrgica. Más particularmente, esta solicitud se refiere a un efector de extremo de un dispositivo de grapadora quirúrgica que tiene un cartucho conectado a un canal de cartucho.
Técnica relacionada
Los dispositivos de aplicación de grapas o de fiadores son bien conocidos, en ellos, estructuras de mordaza en oposición sujetan y fijan tejido seleccionado, que es unido a continuación por medio de fiadores quirúrgicos. Típicamente, uno de los miembros de mordaza incluye un cartucho que aloja una pluralidad de grapas dispuestas en dos o más hileras lineales y el otro miembro de mordaza incluye un yunque que tiene una pluralidad de cavidades para formar grapas para recibir y formar las patas de las grapas. Los dispositivos de grapadora quirúrgica lineal, por ejemplo, incluyen dos miembros de mordaza alargados, movibles uno con relación al otro, para capturar o aprisionar tejido. Cuando el dispositivo de grapadora es disparado sobre un tejido grueso o resistente, el cartucho puede quedar desplazado de un canal de cartucho en el que está contenido si el cartucho no está suficientemente asegurado al canal. El documento de los EE.UU. 5814055 describe una grapadora quirúrgica que se corresponde con el preámbulo de la reivindicación independiente que se adjunta.
SUMARIO
La descripción presente pertenece a un instrumento de aplicación de fiador quirúrgico que incluye un yunque, un conjunto de cartucho que define un eje longitudinal y que tiene un canal de cartucho, el canal de cartucho tiene un extremo distal con un saliente al menos que se extiende transversalmente al eje longitudinal, y un cartucho de fiadores situado dentro del canal de cartucho, el cartucho de fiadores tiene una pluralidad de fiadores quirúrgicos dentro de él y un rebajo al menos para recibir el un saliente al menos. El un saliente al menos comprende un par de salientes que se extienden en sentidos en oposición. El par de salientes forma una extensión con forma de T en el canal de cartucho. El un rebajo al menos forma un rebajo con forma de T que se corresponde con la extensión con forma de T del canal de cartucho. La posición del cartucho de fiadores dentro del canal de cartucho puede ser confirmable por medio de un indicador, por ejemplo, un indicador visual y/o audible. El canal de cartucho puede estar formado de un material que tiene una predisposición en una dirección de tal manera que el cartucho aplica una fuerza alrededor del cartucho de fiadores cuando el cartucho de fiadores está situado dentro del canal de cartucho. El canal de cartucho puede ser un canal con una forma generalmente de U que tiene una extensión que se extiende distalmente. El cartucho de fiadores puede tener lengüetas y el canal de cartucho puede tener ranuras para recibir las lengüetas.
Cuando están ensamblados los diversos conjuntos y sus componentes internos respectivos del efector de extremo, están configurados y adaptados para facilitar la manipulación, aprisionamiento, sujeción, fijación, y/o corte de tejido durante un tratamiento quirúrgico dado. Se describen con mayor detalle realizaciones particulares de la descripción presente haciendo referencia a las Figuras adjuntas en la descripción detallada que sigue a continuación.
BREVE DESCRIPCIÓN DE LOS DIBUJOS
Los dibujos que se acompañan, que están incorporados en y forman parte de la memoria, ilustran la exposición presente cuando se estudia haciendo referencia a la descripción, en la que:
La Figura 1 es una vista en perspectiva de un dispositivo de grapadora quirúrgica que incluye una realización del dispositivo de grapadora quirúrgica aquí descrito; y
La Figura 2 es una vista en perspectiva a escala ampliada de un efector de extremo; y
La Figura 3 es una vista en perspectiva a escala ampliada del efector de extremo de la Figura 2; y
La Figura 4 es una vista en despiece ordenado de un conjunto de cartucho incluido en el efector de extremo de la Figura 1.
BREVE DESCRIPCIÓN DE LOS DIBUJOS
Se describen con detalle realizaciones del dispositivo de grapadora quirúrgica descrito aquí haciendo referencia a los dibujos, en los que los mismos números de referencia designan elementos idénticos o correspondientes en cada
una de las diversas vistas. Como se usa aquí, la expresión “distal” se refiere a la porción de la grapadora quirúrgica,
o componente de ella, más alejada del usuario mientras que la expresión “proximal” se refiere a la porción de esa
porción de la grapadora quirúrgica o componente de ella, más cerca del usuario.
Un instrumento de aplicación de fiadores quirúrgicos lineal, tal como un dispositivo de grapadora 10, mostrado en la Figura 1, incluye un conjunto de empuñadura 16, una porción de cuerpo alargada 18 que define un eje longitudinal A
– A, y un efector de extremo 12. Muchos componentes del dispositivo de grapadora quirúrgica 10 han sido sustancialmente descritos en la patente de los EE.UU. Nº 5.865.361. En particular, el conjunto de empuñadura 16 incluye una empuñadura movible 24 y una empuñadura estacionaria 22. La empuñadura movible 24 es movible mediante un recorrido de activación para sujetar tejido y para efectuar la eyección de las grapas desde un cartucho de grapas del conjunto de cartucho 36 incluido en el efector de extremo 12.
Se contempla que las realizaciones descritas aquí del efector de extremo y/o del conjunto de cartucho descritos aquí puedan ser usadas en asociación con otros dispositivos de grapadora lineal conocidos tanto de construcción endoscópica como abierta. Estos dispositivos incluyen dispositivos articulados y no articulados, así como dispositivos reutilizables y no reutilizables. Ejemplos de dichos dispositivos han sido descritos en las patentes de los EE.UU. Nos. 6.202.914; 6.250.532; 6.032.849; 5.584.425; 5.413.268; 5.312.023; 5.507.426; 6.953.139; y 5.762.256. Dichos dispositivos incluyen, pero no están limitados a, dispositivos de grapadora lineal y dispositivos de grapadora quirúrgica laparoscópicos o endoscópicos.
Como se ha explicado anteriormente, el dispositivo de grapadora quirúrgica 10 incluye un conjunto de empuñadura 16, una porción de cuerpo alargada 18, y un efector de extremo 12. El conjunto de empuñadura 16 incluye un miembro de apriete estacionario 22, un disparador pivotable 24, una palanca de articulación 26, un mando giratorio 27, y un mando de retorno 28. De acuerdo con varias realizaciones, una unidad de carga 20 (también conocida como “SULU” y/o “DLU”) está adaptada para ser aplicada de manera liberable a la porción de cuerpo alargada 18 e incluye una porción de cuerpo proximal 32 y el efector de extremo 12.
El efector de extremo 12 incluye un conjunto de yunque 34 y un conjunto de cartucho 36 que aloja una pluralidad de hileras lineales de grapas. El conjunto de yunque 34 y el conjunto de cartucho 36 son pivotables uno con relación al otro entre una posición abierta y una posición de sujeción o en una aproximada en la que el conjunto de yunque 34 y el conjunto de cartucho 36 están en alineación cooperativa estrecha. El conjunto de cartucho tiene un eje longitudinal y un cartucho de fiadores o un cartucho de grapas 220. El cartucho de grapas 220 incluye una superficie de contacto con el tejido 231 (Figura 4) que está en oposición a una superficie de contacto con el tejido 232 situada en el yunque (mostrada en la Figura 2). La superficie de contacto con el tejido 232 incluye una serie de cavidades formadoras de grapas que están alineadas con aberturas para grapas 223 definidas en la superficie de contacto con el tejido 231 del cartucho de grapas 220. El cartucho de grapas 220 aloja fiadores quirúrgicos, tales como grapas, que están soportados por empujadores dentro de las aberturas para grapas 223 del cartucho 220. Los empujadores se usan para impulsar las grapas contra los rebajos formadores de grapas del conjunto de yunque 34 cuando el cartucho es activado.
El disparador pivotable 24 es activable mediante un recorrido o recorridos de activación para mover el conjunto de yunque 34 con relación al conjunto de cartucho 36 entre una posición abierta y una posición de sujeción y para eyectar grapas desde el cartucho de grapas del conjunto de cartucho 36. Alternativamente, el recorrido de activación puede hacer que el conjunto de cartucho 36 pivote hacia un conjunto de yunque estacionario 34 de tal manera que las grapas pueden ser formadas contra cavidades formadoras de grapas 111.
Como se aprecia mejor en la Figura 4, el dispositivo de grapadora quirúrgica 10 incluye también un conjunto de activación 150, que puede comprender una barra alargada 33 que tiene una hoja 151 en ella, y un carro 160. La barra alargada tiene un extremo distal con una pestaña superior 33a y una pestaña inferior 33b. La pestaña superior se aplica al conjunto de yunque 34 y la pestaña inferior se aplica al conjunto de cartucho 36. Inicialmente, la barra alargada 33 es movida distalmente cuando el disparador pivotable 24 es activado. Una activación posterior del disparador pivotable 24 hace avanzar más lejos la barra alargada. Cuando el carro 160 es situado distalmente respecto a la barra alargada, la barra alargada hace avanzar el carro 160 a través del cartucho de grapas 220. El carro 160 interactúa con los empujadores para impulsar las grapas contra la superficie formadora de grapas del conjunto de yunque 34. El disparador pivotable 24 está configurado para hacer que la barra alargada avance mediante múltiples recorridos y puede tener un trinquete que aplique y desaplique alternativamente una cremallera para hacer que la barra alargada avance mediante múltiples activaciones del disparador pivotable 24.
Se contemplan otros conjuntos de activación. Cuando están ensamblados estos varios conjuntos y sus componentes internos respectivos, permiten que el dispositivo de grapadora quirúrgica lineal 10 manipule, apriete, sujete, aprisione, y/o corte tejido durante un tratamiento quirúrgico dado. El carro 160 está configurado para moverse longitudinalmente a través del cartucho 220 y tiene cuñas para eyectar los fiadores quirúrgicos, tales como las grapas alojadas dentro de las hileras de aberturas para grapas 233. El actuador 150 puede incluir cuñas de leva o superficies de leva en él para impulsar los empujadores. El actuador 150 está asociado, por ejemplo, con el carro 160 montado en él y se desplaza en él, o con él o está conectado a él o es enterizo con él y/o se desplaza por detrás de él. Por ejemplo, El actuador 150 está dispuesto o situado en el carro 160 de tal manera que después de que las grapas han sido disparadas y formadas contra las cavidades formadoras de grapas 111 del conjunto de yunque 34 (Figura 2), la hoja 151 del actuador 150 corta tejido entre las hileras de grapas cuando la hoja 151 se desplaza a través de la ranura de la cuchilla 250 del cartucho 220.
Cuando se unen capas de tejido, el conjunto de yunque 34 y el conjunto de cartucho 36 pueden ser situados en una posición de sujeción o en una aproximada. El efector de extremo 12 puede estar adaptado para acceder a un sitio quirúrgico a través de un dispositivo de acceso (por ejemplo, una cánula) que es conocido en la técnica. Para realizar esto, el efector de extremo 12 que incluye el conjunto de yunque 34 y el conjunto de cartucho 36, como se muestra en la Figura 2, es mantenido en una posición de sujeción o en una aproximada cuando la porción de cuerpo alargada 18 es insertada a través de una cánula (no mostrada). A partir de este momento, las mordazas del efector de extremo 12 (por ejemplo, el conjunto de yunque 34 y el conjunto de cartucho 36) son abiertas de tal manera que el tejido puede ser unido y/o cortado sujetando y activando el dispositivo de grapadora quirúrgica 10.
Haciendo referencia ahora a las Figuras 2 y 3, se ilustra el efector de extremo 12 de acuerdo con una realización de la invención presente. El conjunto del cartucho 36 puede incluir un canal de cartucho 219 y un cartucho de grapas
220. El canal de cartucho 219 está dimensionado y configurado para recibir el cartucho 220 dentro de él. El cartucho 220 incluye lengüetas 222 formadas a lo largo de ambos lados del cartucho 220 dimensionadas y configuradas para ser aseguradas en las ranuras correspondientes 224 formadas a ambos lados del canal de cartucho 219. Las ranuras 224 están configuradas para retener, situar, y alinear dentro de ellas las lengüetas 222 del cartucho. Una ranura longitudinal 230 puede extenderse longitudinalmente a lo largo de la parte superior del canal de cartucho 219. El cartucho 220 puede incluir un saliente, por ejemplo, una pestaña configurada y adaptada para ser aplicada a la ranura longitudinal 230 inhibiendo de esta manera el movimiento del cartucho 220 con relación al canal de cartucho
219. Además, la ranura longitudinal 230 proporciona una indicación visual del cartucho 220 con respecto al canal de cartucho 219 para facilitar la alineación apropiada del cartucho 220 con relación al cartucho 220.
El canal de cartucho 219 incluye salientes 225 formados en o cerca del extremo distal de éste. Los rebajos 223 formados en el cartucho 220 están dimensionados y configurados para aplicar los salientes 225, asegurando y situando de esta manera el cartucho 220 en el canal de cartucho 219. Esta configuración permite que un usuario determine fácilmente si el cartucho 220 está aplicado con seguridad al canal de cartucho 219 y refuerza la conexión entre las ranuras 224 y las lengüetas 222. Los salientes 225 pueden comprender un par de salientes o un saliente único para ser recibidos en un rebajo único. Sin embargo, los salientes 225 forman deseablemente un extremo distal con forma de T en el canal de cartucho 219 y el rebajo 223 forma un rebajo con forma de T para recibir la extensión con forma de T en el extremo distal del canal de cartucho 219. En otras realizaciones, los salientes 225 y los rebajos 223 pueden ser situados en un extremo más distal del canal de cartucho 219. Deseablemente, el uno o más salientes 225 se extienden transversalmente al eje longitudinal del conjunto de cartucho. La expresión transversal, tal como se usa aquí, incluye orientaciones que se extienden en un ángulo con el eje longitudinal del conjunto de cartucho, e incluye orientaciones que se extienden perpendicularmente al eje longitudinal del conjunto de cartucho. El canal de cartucho 219 puede estar formado de un material que tiene una predisposición en una dirección, por ejemplo, hacia el eje longitudinal central del efector de extremo 12, de tal manera que el canal de cartucho 219 aplica una fuerza alrededor del cartucho de grapas 220 cuando el cartucho de grapas 220 está situado dentro del canal de cartucho 219. Los salientes 225 se aplican a los rebajos 223 para mantener el cartucho de grapas 220 dentro del canal de cartucho 219 durante la activación del dispositivo de grapadora quirúrgica 10.
En una realización, las lengüetas 222 pueden tener un color diferente del que tiene el canal de cartucho 219 para permitir que el usuario determine visualmente si el cartucho 220 está alineado apropiadamente dentro del canal de cartucho 219. Se contempla también que pueden emplearse colores diferentes para identificar tipos diferentes de cartuchos que pueden ser instalados en el efector de extremo 12. Alternativamente, las ranuras 224 pueden incluir una cubierta transparente coloreada que parece que cambia de color cuando la lengüeta 222 es situada dentro de la ranura 224, por ejemplo, si la cubierta es azul y la lengüeta 222 es amarilla, el usuario percibirá un color verde cuando el cartucho 220 está en su sitio. En una realización adicional, cuando el cartucho 220 está asegurado al canal de cartucho 219, el usuario puede recibir una señal visual o audible para indicar una alineación apropiada, por ejemplo, una indicación audible tal como un sonido de clic.
Debe entenderse que pueden hacerse varias modificaciones a las realizaciones descritas aquí. Por ejemplo, el tamaño, ángulos y/o curvas de la(s) superficie(s) del conjunto de cartucho puede(n) ser modificado(s) para adaptarse mejor a un tratamiento quirúrgico particular. Por tanto, la descripción anterior no debe ser considerada como limitadora, sino meramente como ejemplificadora de varias realizaciones.

Claims (6)

  1. REIVINDICACIONES
    1. Un instrumento para aplicar fiadores quirúrgicos (10), que comprende:
    un yunque (34);
    un conjunto de cartucho (36) que define un eje longitudinal y que tiene un canal de cartucho (219), teniendo el canal de cartucho (219) un extremo distal con un saliente (225) al menos que se extiende transversalmente al eje longitudinal; y
    un cartucho de fiadores (220) situado dentro del canal de cartucho (219), teniendo el cartucho de fiadores
    (220) una pluralidad de fiadores quirúrgicos dentro de él y un rebajo (223) al menos para recibir el un saliente (225) al menos;
    y en el que:
    el un saliente (225) al menos comprende un par de salientes (225) que se extienden en sentidos en oposición; que se caracteriza porque
    el par de salientes (225) forma una extensión con forma de T del canal de cartucho (219); y porque
    el un rebajo (223) al menos forma un rebajo con forma de T que se corresponde con la extensión en forma de T del canal de cartucho (219).
  2. 2.
    El instrumento para aplicar fiadores quirúrgicos (10) de acuerdo con la reivindicación 1, en el que la posición del cartucho de fiadores (220) dentro del canal de cartucho (219) es confirmable por medio de un indicador.
  3. 3.
    El instrumento para aplicar fiadores quirúrgicos (10) de acuerdo con la reivindicación 1 ó la 2, en el que la situación del cartucho de fiadores (220) dentro del canal de cartucho (219) es confirmable por medio de un indicador audible.
  4. 4.
    El instrumento para aplicar fiadores quirúrgicos (10) de acuerdo con cualquier reivindicación precedente, en el que el canal de cartucho (219) está formado de un material que tiene una predisposición en una dirección de tal manera que el canal de cartucho (219) aplica una fuerza alrededor del cartucho de fiadores (220) cuando el cartucho de fiadores (220) es situado dentro del canal de cartucho (219).
  5. 5.
    El instrumento para aplicar fiadores quirúrgicos (10) de acuerdo con cualquier reivindicación precedente, en el que el canal de cartucho (219) es un canal con forma generalmente de U que tiene una extensión que se extiende distalmente.
  6. 6.
    El instrumento para aplicar fiadores quirúrgicos (10) de acuerdo con cualquier reivindicación precedente, en el que el cartucho de fiadores (220) tiene lengüetas (222) y el canal de cartucho (219) tiene ranuras (224) para recibir las lengüetas (222).
ES10250889T 2009-05-08 2010-05-06 Cartucho para grapadora y enclavador de canal Active ES2388422T3 (es)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US437709 1995-05-09
US12/437,709 US8127976B2 (en) 2009-05-08 2009-05-08 Stapler cartridge and channel interlock

Publications (1)

Publication Number Publication Date
ES2388422T3 true ES2388422T3 (es) 2012-10-15

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US (1) US8127976B2 (es)
EP (1) EP2248475B1 (es)
JP (1) JP2010259789A (es)
AU (1) AU2010201445B2 (es)
CA (1) CA2699947C (es)
ES (1) ES2388422T3 (es)

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AU2010201445A1 (en) 2010-11-25
CA2699947C (en) 2017-05-16
CA2699947A1 (en) 2010-11-08
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EP2248475B1 (en) 2012-07-11
US8127976B2 (en) 2012-03-06

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