ES2636957T3 - Grapas quirúrgicas revestidas y un cartucho de grapas iluminado para un instrumento grapador quirúrgico - Google Patents
Grapas quirúrgicas revestidas y un cartucho de grapas iluminado para un instrumento grapador quirúrgico Download PDFInfo
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Abstract
Un dispositivo grapador quirúrgico (60) que comprende: un mango (64); un miembro tubular alargado (46, 66) que se extiende distalmente desde el mango (64); un cartucho iluminado (48, 62) que contiene grapas montado en un extremo distal del miembro tubular alargado (46, 66), incluyendo el cartucho iluminado (48, 62) que contiene grapas un canal exterior (72) en forma de U, y un inserto transparente (70) que contiene grapas; y una fuente luminosa (106) asociada con el extremo distal del miembro tubular alargado (46, 66) o incorporada directamente en el inserto (70) de cartucho, de manera que la luz emitida desde la fuente luminosa (106) es transmitida al cartucho iluminado (48, 62) que contiene grapas, y una parte de la luz transmitida atraviesa el inserto transparente (70) que contiene grapas hasta el cartucho iluminado (48, 62) que contiene grapas.
Description
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DESCRIPCION
Grapas quirurgicas revestidas y un cartucho de grapas iluminado para un instrumento grapador quirurgico Antecedentes
1. Campo tecnico
La presente revelacion se refiere a grapas quirurgicas para uso en un instrumento grapador quirurgico. Mas particularmente, la presente revelacion se refiere a grapas quirurgicas revestidas para mejorar la visibilidad de su colocacion en tejido. La presente revelacion se refiere ademas a un cartucho de grapas que tiene iluminacion interna para mejorar la visibilidad de la posicion del cartucho en el tejido y la colocacion de los componentes internos del cartucho de grapas.
2. Antecedentes de la tecnica relacionada
Durante ciertas intervenciones quirurgicas se utilizan diversos dispositivos grapadores quirurgicos para aplicar una o mas filas de grapas al tejido y, en algunos casos, cortar el tejido entre las filas de grapas. La visibilidad del extremo distal del dispositivo grapador usado dentro del cuerpo de un paciente es importante para asegurar la colocacion apropiada del dispositivo grapador alrededor del tejido. La capacidad para monitorizar visualmente el extremo distal del dispositivo grapador quirurgico tambien es util para determinar la cantidad de tejido que ha sido realmente grapada y/o la cantidad de tejido que ha sido cortada realmente por el dispositivo grapador quirurgico.
La capacidad de visualizar el extremo distal del dispositivo grapador quirurgico es mas diffcil cuando el dispositivo grapador quirurgico se usa endoscopica o laparoscopicamente. En estas situaciones, el dispositivo grapador quirurgico se inserta dentro del cuerpo a traves de un orificio del cuerpo. La operacion quirurgica se realiza bajo visualizacion a traves de un endoscopio o laparoscopio que tiene un campo de vision limitado. Esto puede dificultar la verificacion de que el dispositivo grapador quirurgico haya funcionado adecuadamente y la evaluacion de la integridad de la lmea de grapas conformada por el dispositivo grapador quirurgico.
La capacidad para evaluar la integridad de la lmea de grapas puede verse obstaculizada por el uso de grapas convencionales conformadas de acero inoxidable y/o titanio, ya que estos materiales tienden a reflejar la luz de vuelta hacia la lente en el endoscopio o laparoscopio oscureciendo una vista clara de la lmea de grapas.
El documento W02007/005621 describe un sistema y un metodo para localizar dispositivos de fijacion de tejido reabsorbibles de plastico.
El documento EP-A-1 362 554 describe un sistema para asegurar tejido corporal.
El documento US-A-5 395 030 describe un dispositivo quirurgico para grapar y fijartejidos corporales.
El dispositivo quirurgico comprende un yunque y un cartucho con una ventana de iluminacion y una ventana de observacion.
Asf, existe la necesidad de un dispositivo grapador quirurgico que tenga un extremo distal que pueda ser mas visible dentro del cuerpo del paciente durante el uso. Tambien existe la necesidad de un sujetador quirurgico capaz de ser visualizado claramente dentro del cuerpo sin reflejar cantidades significativas de luz de vuelta al dispositivo de visualizacion.
Sumario
Los aspectos y realizaciones de la presente invencion se exponen en las reivindicaciones. Un sujetador quirurgico esta conformado con una grapa quirurgica en forma de U convencional que tiene un travesano posterior y un par de patas que se extienden distalmente desde el travesano posterior. Cada una de las patas termina en una punta de penetracion de tejido. La grapa quirurgica esta revestida de un material configurado para mejorar la visibilidad de la grapa quirurgica dentro del tejido, mientras que al mismo tiempo reduce la reflectividad de la grapa quirurgica. En una realizacion espedfica, las puntas de penetracion de tejido de la grapa quirurgica no estan revestidas para evitar el embotamiento de las puntas afiladas.
En una realizacion alternativa, el sujetador quirurgico esta conformado como un sujetador de bobina helicoidal que tiene una punta afilada distal de penetracion de tejido en una bobina proximal comprimida que facilita la insercion en el tejido. El sujetador de bobina helicoidal revelado esta revestido para mejorar la visibilidad mientras se reduce la reflectividad.
Tambien se revela un cartucho de grapas para uso con un dispositivo grapador quirurgico que tiene una fuente luminosa. El cartucho de grapas incluye generalmente un miembro de canal exterior en forma de U y un inserto transparente situado dentro del miembro de canal exterior en forma de U. El inserto transparente incluye una porcion de cuerpo que tiene un borde delantero conico y una superficie orientada hacia arriba para emitir luz. En una realizacion particular, el canal exterior en forma de U esta conformado con una serie de ventanas que se extienden
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longitudinalmente y que permiten que la luz transmitida a traves de unas superficies laterales del inserto transparente pase a traves del mismo. Durante el uso, el posicionamiento relativo de los impulsores de grapas y una hoja de cuchilla, asociada con un dispositivo grapador quirurgico, atenuan la cantidad de luz que pasa a traves del inserto transparente y sale a traves de las ventanas en el canal exterior en forma de U. El trineo o los empujadores bloquearan cualquier luz hacia ventanas distales de la luz hasta que esta progrese mas alla, indicando asf el estado posicional de la lmea de grapas.
Tambien se revela un dispositivo grapador quirurgico que tiene un cartucho de grapas para facilitar la colocacion visual del extremo distal del dispositivo grapador quirurgico dentro de tejido. El cartucho de grapas esta situado en un extremo distal del dispositivo grapador quirurgico de tal manera que una fuente luminosa asociada con el dispositivo grapador quirurgico esta en una posicion para transmitir luz al inserto transparente asociado con el cartucho de grapas.
Descripcion de los dibujos
Se revelan en el presente documento diversas realizaciones de las grapas quirurgicas y del instrumento quirurgico actualmente revelados, que incorporan un cartucho de grapas iluminado, con referencia a los dibujos, en los que:
La figura 1 es una vista lateral de una grapa quirurgica revestida;
La figura 1A es una vista extrema, mostrada parcialmente en seccion, de la grapa quirurgica revestida de la figura 1;
La figura 2 es una vista lateral de una realizacion alternativa de una grapa quirurgica revestida;
La figura 2A es una vista lateral, mostrada parcialmente en seccion, de la grapa quirurgica revestida de la figura 2;
La figura 3 es una vista en perspectiva del extremo distal de un dispositivo grapador quirurgico situado alrededor de una seccion de tejido tubular;
La figura 4 es una vista en perspectiva del extremo distal del dispositivo grapador quirurgico y la seccion de tejido tubular de la figura 3 despues de grapar y cortar la seccion de tejido tubular;
La figura 5 es una vista en perspectiva de un dispositivo grapador quirurgico que incorpora un cartucho de grapas para iluminar el extremo distal del dispositivo grapador quirurgico;
La figura 6 es una vista en perspectiva, con partes separadas, del extremo distal del dispositivo grapador quirurgico;
La figura 7 es una vista en perspectiva del extremo distal ensamblado e iluminado del dispositivo grapador quirurgico;
La figura 8 es una vista en perspectiva del extremo distal del dispositivo grapador quirurgico, con un yunque en la posicion abierta, parcialmente iluminado durante una carrera de grapado;
La figura 9 es una vista en perspectiva del extremo distal del dispositivo grapador quirurgico, con el yunque en la posicion abierta, parcialmente iluminado durante una carrera de corte; y
La figura 10 es una vista en perspectiva del extremo distal parcialmente iluminado del dispositivo grapador quirurgico situado alrededor de una seccion de tejido tubular.
Descripcion detallada de las realizaciones
Las realizaciones de los sujetadores quirurgicos y del dispositivo grapador quirurgico actualmente revelados se describiran ahora en detalle con referencia a los dibujos en los que numeros iguales designan elementos identicos o correspondientes en cada una de las diversas vistas. Como es comun en la tecnica, el termino “proximal” se refiere a aquella parte o componente mas cercano al usuario u operador, es decir cirujano o medico, mientras que el termino “distal” se refiere a aquella parte o componente mas alejado del usuario.
Haciendo referencia a la figura 1, se revela un sujetador quirurgico o grapa quirurgica 10 que incluye un revestimiento, coloracion u otro material para ayudar a ver la grapa dentro del cuerpo de un paciente y para ayudar a ver la formacion apropiada de la grapa 10 dentro de la forma completamente conformada en “B” caractenstica. La grapa 10 incluye generalmente un travesano posterior 12 que tiene unas patas primera y segunda 14 y 16, respectivamente, que se extienden distalmente desde el travesano posterior 12. La primera pata 14 termina en una punta 18 de penetracion de tejido y la segunda pata 16 termina en una punta 20 de penetracion de tejido similar.
Haciendo referencia a las figuras 1 y 1A, la grapa 10 incluye un nucleo 22 que tiene un revestimiento activo 24 aplicado al nucleo 22. El nucleo 22 puede estar conformado de una sustancia metalica tal como, por ejemplo, acero inoxidable, titanio u otro material deformable/maleable, etc. El revestimiento activo 24 puede incluir materiales que tienen fluorescencia molecular, fosforescencia molecular, quimioluminiscencia, etc. que emiten rayos visibles "R" que permiten que la grapa 10 se visualice facilmente dentro del cuerpo de un paciente. Revistiendo el nucleo 22 con uno
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o mas de estos revestimientos activos 24, la grapa 10 puede visualizarse dentro del cuerpo de un paciente sin depender de la luz substancialmente reflejada. Por ejemplo, algunos de los revestimientos anteriores pueden ser activados por luz ultravioleta de tal manera que fluorescen o "brillan en la oscuridad". Alternativamente, otros de los revestimientos anteriores emiten sus propias fuentes luminosas para facilitar la visualizacion de la grapa o pueden emitir luz no visible de tal manera que la grapa pueda verse debido al contraste sustancial contra el tejido subyacente.
En la formacion de la grapa 10, los revestimientos 24 descritos anteriormente pueden aplicarse al nucleo 22 por numerosos medios bien conocidos en la tecnica. Por ejemplo, los revestimientos 24 se pueden aplicar mediante los siguientes metodos: anodizacion, tintado, electrorevestimiento, revestimiento fotoluminiscente, aplicacion de nitruros, metacrilato de metilo, pintura, revestimiento en polvo, revestimiento con parafinas, manchas de aceite o revestimientos de fosforo, uso de hidroxiapatito, polfmeros, oxinitruros de titanio, sulfuros de cinc, carburos, etc. Debe observarse que, aunque los revestimientos enumerados 24 son bastante espedficos como se revela en el presente documento, otros revestimientos conocidos en la tecnica para mejorar la visibilidad del nucleo 22 estan dentro del alcance contemplado de la presente revelacion.
Durante el revestimiento espedfico del nucleo 22 con revestimientos 24, las puntas 18 y 20 de penetracion de tejido pueden enmascararse o cubrirse de otro modo para evitar que reciban el revestimiento 24. Esto puede ser deseable para evitar el embotamiento de las puntas 18 y 20 de penetracion de tejido permitiendo asf que las puntas 18 y 20 penetren mas limpiamente en el tejido.
Con referencia ahora a las figuras 2 y 2A, e inicialmente con respecto a la figura 2, se revela un sujetador alternativo o sujetador de bobina 30 configurado tambien para ser visualizado facilmente dentro del tejido sin la ayuda de luz reflejada. El sujetador de bobina 30 incluye generalmente un cuerpo de bobina helicoidal 32 que tiene una punta 34 de penetracion de tejido conformada en un extremo distal 36 del cuerpo de bobina helicoidal 32. El cuerpo de bobina helicoidal 32 incluye adicionalmente una bobina extrema proximal comprimida 38 para facilitar la conduccion del sujetador de bobina 30 hacia el interior del tejido.
Haciendo referencia espedficamente a la figura 2A, y como la grapa 10 descrita anteriormente, el sujetador de bobina 30 incluye un nucleo metalico 40 que tiene un revestimiento activo 42 aplicado al mismo. El revestimiento 42 tambien emite rayos visibles "R" que permiten que el sujetador de bobina 30 se visualice facilmente dentro del tejido. El revestimiento 42 se forma a partir del, y se aplica al, nucleo 40 de maneras similares a las descritas anteriormente con respecto a la grapa 10. Al igual que con las puntas 18 y 20 de penetracion de tejido descritas anteriormente con respecto a la grapa 10, la punta 34 de penetracion de tejido puede estar cubierta durante el revestimiento para evitar el embotamiento.
Haciendo referencia ahora a las figuras 3 y 4, e inicialmente con respecto a la figura 3, se describira ahora el uso de un dispositivo grapador quirurgico (no mostrado) que tiene una porcion de extremo distal 44 para aplicar un sujetador, tal como, por ejemplo, la grapa 10 al tejido. La porcion del extremo distal 44 incluye un miembro tubular alargado 46 que tiene un cartucho 48 de grapas montado en el. Un miembro de yunque 50 esta unido de forma movil a un miembro tubular alargado 46 y es movible entre una posicion abierta sustancialmente separada del cartucho 48 de grapas hasta una posicion cerrada sustancialmente adyacente al cartucho 48 de grapas.
Con referencia a la figura 4, el cartucho 48 de grapas esta conformado con una ranura 52 de cuchilla que se extiende longitudinalmente a traves del cartucho 48 de grapas. Una hoja 54 de cuchilla se asocia con el extremo distal 44 y se puede mover a traves de la ranura 52 de cuchilla para seccionar tejido capturado entre el cartucho 48 de grapas y el miembro de yunque 50. El cartucho 48 de grapas incluye ademas multiples filas de grapas 10 situadas dentro de las cavidades 56 de grapas para aplicacion a un tejido, tal como una seccion de tejido tubular T. En uso, el extremo distal 44 se aplica a la seccion de tejido T de manera que la seccion de tejido T quede capturada entre el cartucho 48 de grapas y el miembro de yunque 50 montado de manera movil sobre el miembro tubular alargado 46. A continuacion, se acciona la grapadora quirurgica para expulsar las grapas 10 de unas cavidades 56 de grapas dentro del cartucho 48 de grapas, a traves de la seccion de tejido T y dentro del miembro de yunque 50, grapando asf la seccion de tejido T de una manera conocida. A continuacion, se hace avanzar la hoja 54 de cuchilla a traves de la ranura 52 de cuchilla para cortar la seccion de tejido tubular T entre las filas de grapas 10 ahora aplicadas a la seccion de tejido tubular T.
Tras la retirada del extremo distal 44 de la grapadora quirurgica de alrededor de la seccion de tejido tubular T, las filas de grapas 10, asf como la formacion apropiada de cada grapa individual 10, pueden visualizarse facilmente en los extremos ahora libres de la seccion de tejido tubular T por los rayos "R" emitidos desde las grapas 10. De este modo, el correcto posicionamiento y formacion de las grapas 10 dentro de una seccion de tejido se puede visualizar facilmente sin resultar obscurecido por la luz reflejada.
Con referencia ahora a la figura 5, se revela una grapadora quirurgica 60 que tiene un cartucho 62 de grapas que incorpora una o mas fuentes luminosas para facilitar la visualizacion del posicionamiento del cartucho 62 de grapas dentro del cuerpo de un paciente. Ademas, como se describe con mas detalle a continuacion, el cartucho 62 de grapas tambien proporciona una indicacion del funcionamiento adecuado de la grapadora quirurgica 60 cuando aplica grapas a tejido y corta el tejido grapado. La grapadora quirurgica 60 incluye generalmente un mango 64 de
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agarre de pistola que tiene un miembro tubular alargado 66 que se extiende distalmente desde el mango 64 de agarre de pistola. El cartucho de grapas iluminado 62 esta montado en un extremo distal 68 del miembro tubular alargado 66 e incluye un inserto 70 de cartucho transparente alojado dentro de un canal exterior 72 generalmente en forma de U. El inserto 70 de cartucho esta dispuesto para transmitir radiacion optica, en forma de luz visible, al area que rodea el cartucho de grapas iluminado 62, mientras que el canal exterior 72 en forma de U protege una parte de la radiacion optica. Una o mas fuentes luminosas pueden asociarse con la grapadora quirurgica 60 para proporcionar una fuente luminosa para iluminar el cartucho 62 de grapas.
Un miembro de yunque 74 esta montado de manera movil en el extremo distal 68 del miembro tubular alargado 66. El miembro de yunque 74 es movil desde una posicion abierta separada del cartucho de grapas iluminado 62 hasta una posicion cerrada sustancialmente adyacente al cartucho de grapas iluminado 62. Un gatillo 76 esta dispuesto en el mango 64 de agarre de pistola del miembro de yunque 74 entre las posiciones abierta y cerrada, asf como para expulsar grapas del cartucho de grapas iluminado 62 de una manera descrita con mas detalle a continuacion. Finalmente, se proporciona un collar de rotacion 78 para hacer girar el elemento tubular alargado 66 y orientar el cartucho de grapas iluminado 62 y el miembro de yunque 74 con respecto al tejido.
Con referencia ahora a la figura 6, el inserto 70 de cartucho incluye generalmente una porcion de cuerpo 80 que tiene un borde delantero conico 82. Como se ha indicado anteriormente, la porcion de cuerpo 80 es transparente a la radiacion optica de manera que una vez que se aplica una fuente luminosa a la porcion de cuerpo 80, se emiten rayos luminosos desde una superficie frontal 84, unas superficies laterales 86 y 88, asf como desde una superficie inferior 90 de la porcion de cuerpo 80.
La porcion de cuerpo 80 incluye adicionalmente una pluralidad de cavidades 92 de grapas que contienen grapas 94 para su insercion en el tejido. Las grapas 94 pueden ser de tipo convencional o pueden ser similares a las descritas con respecto a la grapa 10 anterior. Los impulsores 96 y 98 de grapas estan dispuestos para extenderse dentro de ranuras correspondientes en el inserto 70 de cartucho e impulsar las grapas 94 fuera de las cavidades 92 de grapa y dentro del tejido. Una ranura 100 de cuchilla se extiende longitudinalmente a traves de la porcion de cuerpo 80 y la superficie frontal 84. Una hoja 102 de cuchilla esta asociada con la grapadora quirurgica 60 y es movil a traves de la ranura 100 de cuchilla para seccionar el tejido capturado entre el cartucho de grapas iluminado 62 y el miembro de yunque 74.
Como se muestra, el miembro de canal exterior 72 en forma de U incluye una pluralidad de ventanas 104. Las ventanas 104 estan dispuestas para el paso de rayos luminosos desde las superficies laterales 86 y 88 de la porcion de cuerpo 80. Las ventanas 104 pueden usarse adicionalmente utilizarse como estructuras de montaje para unas proyecciones correspondientes conformadas en la porcion de cuerpo 80 (no mostrada) con el fin de facilitar el montaje del inserto 70 de cartucho dentro del canal exterior 72 en forma de U.
Como se ha indicado anteriormente, la grapadora quirurgica 60 puede estar provista de diversas fuentes luminosas para facilitar la iluminacion del inserto 70 y a traves del mismo. En una realizacion, la grapadora quirurgica 60 esta provista de una fuente luminosa 106 colocada dentro del extremo distal 68 del miembro tubular alargado 66. La fuente luminosa 106 puede incluir una o mas luces, incluyendo luces LED, luces incandescentes, luces electroluminiscentes, fuentes luminosas que utilizan bombillas de xenon o halogenas, etc., o puede canalizarse hacia su ubicacion deseada por unos filamentos o cables de fibra optica, aunque la fuente luminosa 106 se describe como colocada dentro del extremo distal 68 del miembro tubular alargado 66, la fuente luminosa 106 puede incorporarse de manera alternativa directamente en el inserto 70 de cartucho. En una realizacion alternativa, la fuente luminosa 106 puede ser un aditivo infundido en el inserto 70 de cartucho que tiene una luz fluorescente reactiva UV o un aditivo fosforescente para permitir que el cartucho 70 sea visible. Ademas, se pueden utilizar medios adicionales para canalizar una fuente luminosa a traves de un conducto de fibra optica hacia el inserto 70 de cartucho. Las superficies del inserto 70 de cartucho pueden pulirse o revestirse con un material reflectante para amplificar y enfocar la fuente luminosa adelante hacia el borde delantero conico 82 de la porcion de cuerpo 80.
Aunque no se muestra espedficamente, la grapadora quirurgica 60 y, en particular, el mango 64 pueden estar provistos de diversos medios conocidos de suministro de luz y/o electricidad, al cartucho 62 de grapas. Son bien conocidos en la tecnica diversos medios conocidos de suministro de electricidad junto con mecanismos de conmutacion con respecto a dispositivos de electrocauterizacion y pueden ser incorporados en el mango 64.
Con referencia ahora a la figura 7 y, como se ha indicado anteriormente, la iluminacion del inserto 70 de cartucho provoca que los rayos luminosos "R" sean emitidos desde la porcion de cuerpo 80. Espedficamente, como se muestra, los rayos luminosos "R" se emiten desde el borde delantero conico 82 y la superficie frontal 84 con el fin de permitir el posicionamiento apropiado del cartucho de grapas iluminado 62 dentro del cuerpo de un paciente. Ademas, cuando la porcion de cuerpo 80 se proyecta distalmente mas alla del canal exterior 72 en forma de U, los rayos luminosos que emanan de la superficie inferior 90 pueden usarse para determinar la orientacion espedfica del miembro de yunque 74 y el cartucho de grapas iluminado 62 dentro del cuerpo de un paciente. Ademas, los rayos luminosos "R" emitidos desde las superficies laterales 86 y 88 se proyectan a traves de las ventanas 104 conformadas en el canal exterior 72 en forma de U. La intensidad de los rayos luminosos "R" emitidos a traves de las ventanas 104 puede utilizarse tambien para dar una indicacion general del posicionamiento de los impulsores 96 y
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98 de grapas, asf como de la posicion de la hoja 102 de cuchilla dentro de la porcion de cuerpo 80 del inserto 70 de cartucho y/o del miembro de yunque 74.
Con referencia ahora a las figuras 8 y 9, el movimiento de los impulsores 96 y 98 de grapas, asf como el movimiento de la hoja 102 de cuchilla dentro de la porcion de cuerpo 80 del inserto 70 de cartucho, bloquea la transmision interna de una porcion de la luz proporcionada al inserto 70 de cartucho por la fuente luminosa 106. Con referencia espedfica a la figura 8, cuando el impulsor 96 de grapas se mueve distalmente dentro de la porcion de cuerpo 80 para expulsar las grapas 94 fuera de las cavidades 92 de grapas, el impulsor 96 de grapas bloquea la cantidad sustancial de luz interna hacia la porcion de cuerpo 80 disminuyendo o eliminando asf en gran medida la cantidad de luz proyectada desde las ventanas 104 en el canal 72 en forma de U. Durante el uso, el cirujano puede aprovechar esta caractenstica observando cuantas ventanas 104 adyacentes al extremo proximal del cartucho 62 de grapas iluminado no estan emitiendo luz, dando de este modo una indicacion de la posicion del impulsor 96 de grapas y, por tanto, una indicacion de que grapas 94 han sido realmente disparadas dentro del tejido.
Como se muestra en la figura 9, a medida que la hoja 102 de cuchilla avanza dentro de la ranura 100 de cuchilla conformada dentro de la porcion de cuerpo 80, se impide que una cantidad espedfica de luz procedente de un lado de la porcion de cuerpo 80 se transmita al lado opuesto de la porcion de cuerpo 80 por la presencia de la hoja 102 de cuchilla. Esto da como resultado que se proyecta una cantidad reducida o disminuida de rayos luminosos “R1” fuera de las ventanas 104 del canal exterior 72 en forma de U. De este modo, puede determinarse la posicion de la hoja 104 de cuchilla dentro del cartucho de grapas iluminado 62 durante su uso por el cirujano con el fin de asegurar que se ha cortado completamente una seccion de tejido del sujeto.
Con referencia ahora a la figura 10, en situaciones en las que la seccion de tejido del sujeto, tal como, por ejemplo, la seccion de tejido T esta oscurecida, es decir, no es completamente visible para el cirujano, el cartucho de grapas iluminado 62 puede usarse de manera que identifique la ubicacion de la seccion de tejido T y/o asegure que la seccion de tejido T ha sido apropiadamente agarrada entre el cartucho de grapas iluminado 62 y el miembro de yunque 74. Por ejemplo, como se muestra, cuando se ve ligeramente desde arriba, la seccion de tejido T oscurece los rayos luminosos emitidos desde la mayona de las ventanas 104, al tiempo que permite que los rayos luminosos sean visibles fuera del borde delantero conico 82 y de una ventana mas distal 104.
Asf, de esta manera se puede ver que el cartucho 62 de grapas puede utilizarse para indicar tanto el posicionamiento del extremo distal de la grapadora quirurgica dentro del cuerpo de un paciente como una indicacion dada de las posiciones relativas de los impulsores de grapas y de la hoja de cuchilla dentro del propio cartucho 62 de grapas.
Se entendera que se pueden hacer diversas modificaciones a las realizaciones reveladas en el presente documento. Por ejemplo, la revelacion anterior puede referirse a sujetadores distintos de los sujetadores de grapa y de bobina helicoidal convencionales revelados tales como, por ejemplo, pinzas quirurgicas, sujetadores de dos partes, etc. Ademas, aunque la revelacion anterior se da con respecto a la iluminacion de un cartucho de grapas y un dispositivo grapador quirurgico, la presente revelacion puede encontrar una utilidad igual cuando se incorpora en un instrumento quirurgico que tiene un par de mandfbulas que iluminan una o ambas mandfbulas para facilitar la visualizacion de la orientacion del instrumento quirurgico dentro de un paciente. Adicionalmente, y como se ha indicado anteriormente, el inserto revelado dentro del cartucho de grapas iluminado y/o el yunque pueden ser completamente transparentes o pueden incluir zonas o regiones espedficas de transparencia para facilitar la visualizacion por parte de un operador. Por lo tanto, la descripcion anterior no debe interpretarse como limitativa, sino meramente como unas ejemplificaciones de realizaciones particulares. Los expertos en la tecnica concebiran otras modificaciones dentro del alcance de las reivindicaciones adjuntas.
Se proporciona un sujetador quirurgico revestido para una facil visualizacion dentro del tejido. El sujetador quirurgico revestido incluye un nucleo y un revestimiento relativamente no reflectante aplicado alrededor del nucleo. Tambien se revela un cartucho de grapas iluminado para uso con un dispositivo grapador quirurgico que tiene una fuente luminosa. El cartucho de grapas iluminado incluye un inserto transparente y un canal exterior en forma de U relativamente no transparente que rodea al menos parcialmente el inserto transparente. Unas ventanas conformadas en unos lados del canal exterior en forma de U permiten que se proyecten cantidades definidas de luz desde los lados del cartucho de grapas iluminado.
Claims (15)
- 510152025303540REIVINDICACIONES1. Un dispositivo grapador quirurgico (60) que comprende: un mango (64);un miembro tubular alargado (46, 66) que se extiende distalmente desde el mango (64);un cartucho iluminado (48, 62) que contiene grapas montado en un extremo distal del miembro tubular alargado (46, 66), incluyendo el cartucho iluminado (48, 62) que contiene grapas un canal exterior (72) en forma de U, y un inserto transparente (70) que contiene grapas; yuna fuente luminosa (106) asociada con el extremo distal del miembro tubular alargado (46, 66) o incorporada directamente en el inserto (70) de cartucho, de manera que la luz emitida desde la fuente luminosa (106) es transmitida al cartucho iluminado (48, 62) que contiene grapas, y una parte de la luz transmitida atraviesa el inserto transparente (70) que contiene grapas hasta el cartucho iluminado (48, 62) que contiene grapas.
- 2. El dispositivo grapador quirurgico (60) segun la reivindicacion 1, en el que el canal exterior (72) en forma de U incluye una pluralidad de ventanas (104).
- 3. El dispositivo grapador quirurgico (60) segun la reivindicacion 2, en el que una parte de la luz transmitida atraviesa la pluralidad de ventanas (104).
- 4. El dispositivo grapador quirurgico segun la reivindicacion 1, en el que el inserto transparente (70) que contiene grapas incluye una porcion de cuerpo transparente (80).
- 5. El dispositivo grapador quirurgico segun la reivindicacion 4, en el que se iluminan rayos de luz desde una superficie frontal (84), unas superficies laterales (86, 88) y una superficie inferior (90) de la porcion de cuerpo (80).
- 6. El dispositivo grapador quirurgico segun la reivindicacion 4 o la reivindicacion 5, en el que la porcion de cuerpo (80) incluye una pluralidad de cavidades (92) de grapas que contienen unas grapas (94) para su insercion en tejido.
- 7. El dispositivo grapador quirurgico segun la reivindicacion 6, en el que las grapas (94) comprenden: un material de nucleo (22) que tiene al menos una punta (18) de penetracion de tejido; y un revestimiento (24) aplicado a al menos una porcion del material de nucleo (22), emitiendo el revestimiento rayos visibles.
- 8. El dispositivo grapador quirurgico segun la reivindicacion 7, en el que el revestimiento (24) tiene una fluorescencia molecular o una fosforescencia molecular o es quimioluminiscente.
- 9. El dispositivo grapador quirurgico segun la reivindicacion 7, en el que la al menos una punta (18) de penetracion de tejido del sujetador esta sin revestir.
- 10. El sujetador quirurgico segun la reivindicacion 7, en el que el material de nucleo (22) esta conformado como un travesano posterior (12) y una pata (14) que se extiende desde cada extremo del travesano posterior (12).
- 11. El sujetador quirurgico segun la reivindicacion 10, en el que cada pata (14) que se extiende desde el travesano posterior (12) termina en la punta (18) de penetracion de tejido.
- 12. El sujetador quirurgico segun la reivindicacion 7, en el que el material de nucleo (22) esta conformado como una bobina helicoidal que termina en una punta (18) de penetracion de tejido en un extremo y en una bobina comprimida en un extremo opuesto.
- 13. El sujetador quirurgico segun la reivindicacion 1, en el que la fuente luminosa (106) incluye una o mas luces, incluyendo luces LED, luces incandescentes, luces electroluminiscentes, fuentes luminosas que utilizan bombillas de xenon o halogenas.
- 14. El sujetador quirurgico segun la reivindicacion 1, en el que la fuente luminosa (106) se canaliza hacia su ubicacion mediante filamentos o cables de fibra optica.
- 15. El sujetador quirurgico segun la reivindicacion 1, en el que las superficies del inserto (70) de cartucho estan pulidas o revestidas con un material reflectante.
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JP4257270B2 (ja) | 2004-07-14 | 2009-04-22 | オリンパス株式会社 | 生体組織縫合方法及び生体組織縫合器 |
US8097017B2 (en) * | 2004-10-18 | 2012-01-17 | Tyco Healthcare Group Lp | Surgical fasteners coated with wound treatment materials |
US20070005071A1 (en) | 2005-06-30 | 2007-01-04 | Cannuflow, Inc. | System and method for locating resorbable tissue fixation devices |
CN1330277C (zh) * | 2005-07-26 | 2007-08-08 | 张祖仁 | 外科用缝合器 |
US7407075B2 (en) | 2005-08-15 | 2008-08-05 | Tyco Healthcare Group Lp | Staple cartridge having multiple staple sizes for a surgical stapling instrument |
DE502005009238D1 (de) | 2005-10-07 | 2010-04-29 | Brainlab Ag | Medizintechnische Markereinrichtung |
-
2008
- 2008-10-31 US US12/262,243 patent/US7954687B2/en not_active Expired - Fee Related
- 2008-11-04 CA CA2918901A patent/CA2918901A1/en not_active Abandoned
- 2008-11-04 CA CA2642796A patent/CA2642796C/en not_active Expired - Fee Related
- 2008-11-05 EP EP08253611A patent/EP2057948A3/en not_active Ceased
- 2008-11-05 JP JP2008284816A patent/JP2009160379A/ja active Pending
- 2008-11-05 EP EP12163643.5A patent/EP2476379B1/en not_active Not-in-force
- 2008-11-05 ES ES12163643.5T patent/ES2636957T3/es active Active
- 2008-11-05 AU AU2008243121A patent/AU2008243121B2/en not_active Ceased
- 2008-11-06 CN CNA2008101735828A patent/CN101427935A/zh active Pending
- 2008-11-06 CN CN201410267800.XA patent/CN104013448B/zh not_active Expired - Fee Related
- 2008-11-06 CN CN201210004737.1A patent/CN102525585B/zh not_active Expired - Fee Related
-
2014
- 2014-03-18 JP JP2014054430A patent/JP2014195657A/ja not_active Ceased
-
2015
- 2015-06-03 JP JP2015112821A patent/JP2015186584A/ja active Pending
-
2017
- 2017-05-23 JP JP2017101519A patent/JP2017176855A/ja active Pending
Also Published As
Publication number | Publication date |
---|---|
CA2918901A1 (en) | 2009-05-06 |
CN104013448A (zh) | 2014-09-03 |
CN102525585A (zh) | 2012-07-04 |
US7954687B2 (en) | 2011-06-07 |
EP2476379B1 (en) | 2017-07-12 |
EP2476379A1 (en) | 2012-07-18 |
JP2015186584A (ja) | 2015-10-29 |
EP2057948A3 (en) | 2009-09-30 |
JP2017176855A (ja) | 2017-10-05 |
JP2009160379A (ja) | 2009-07-23 |
AU2008243121B2 (en) | 2014-01-23 |
CN102525585B (zh) | 2015-02-18 |
CA2642796C (en) | 2016-04-12 |
JP2014195657A (ja) | 2014-10-16 |
CN104013448B (zh) | 2018-10-30 |
AU2008243121A1 (en) | 2009-05-21 |
US20090114701A1 (en) | 2009-05-07 |
EP2057948A2 (en) | 2009-05-13 |
CA2642796A1 (en) | 2009-05-06 |
CN101427935A (zh) | 2009-05-13 |
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