ES2660421T3 - Cabezal de manipulación vaginal con indicador de tejido y prolongador del cabezal - Google Patents

Cabezal de manipulación vaginal con indicador de tejido y prolongador del cabezal Download PDF

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Publication number
ES2660421T3
ES2660421T3 ES13173373.5T ES13173373T ES2660421T3 ES 2660421 T3 ES2660421 T3 ES 2660421T3 ES 13173373 T ES13173373 T ES 13173373T ES 2660421 T3 ES2660421 T3 ES 2660421T3
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Spain
Prior art keywords
head
vagina
vaginal
extension
distal end
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Active
Application number
ES13173373.5T
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English (en)
Inventor
Sarah J. Deitch
M.D. Ty Erickson
Allen Gaynor
Jeffrey Brian Taylor
Michael M. Witzmann
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Coloplast AS
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Coloplast AS
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • A61B17/4241Instruments for manoeuvring or retracting the uterus, e.g. during laparoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/0084Material properties low friction
    • A61B2017/00849Material properties low friction with respect to tissue, e.g. hollow organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • A61B2017/4216Operations on uterus, e.g. endometrium
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42Gynaecological or obstetrical instruments or methods
    • A61B2017/4216Operations on uterus, e.g. endometrium
    • A61B2017/4225Cervix uteri
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03Automatic limiting or abutting means, e.g. for safety

Landscapes

  • 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)
  • Gynecology & Obstetrics (AREA)
  • Pregnancy & Childbirth (AREA)
  • Reproductive Health (AREA)
  • Surgical Instruments (AREA)

Abstract

Un manipulador vaginal (20), que comprende: un cabezal (26) configurado de modo que manipule las paredes de una vagina en la cúpula vaginal, donde el cabezal (26) tiene un primer extremo (40), conectado a un extremo distal de un eje (22), y un extremo distal (42), opuesto al primer extremo (40), un lado anterior (44) opuesto a un lado posterior (46), un primer borde lateral (70) que se extiende entre los lados anterior (44) y posterior (46), y un segundo borde lateral (72) que se extiende entre los lados anterior (44) y posterior (46); y un prolongador del cabezal (30) que se puede acoplar, con posibilidad de desmontarse, al extremo distal del cabezal (26); caracterizado por que el manipulador vaginal (20) comprende, además un indicador de tejido (400) acoplado al cabezal (26), donde el indicador de tejido (400) incluye un primer brazo (402) que se acopla, con el deslizamiento permitido, con una primera acanaladura (404) formada en el primer borde lateral (70) del cabezal (26), un segundo brazo (412) que se acopla, con el deslizamiento permitido, con una segunda acanaladura (414) formada en el segundo borde lateral (72) del cabezal (26), y una nervadura (420) conectada entre el primer (402) y segundo (412) brazo y dispuesta lateralmente a través del lado anterior (44) del cabezal (26); y una puerta (28) acoplada al lado posterior (46) del cabezal (26) y que se puede mover con relación a este.

Description

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cabezal 126 en un punto de pivotamiento y realiza su función de una manera similar a la puerta 28 descrita anteriormente.
El actuador 34 se proporciona para mover la puerta 128 en una dirección en la que pivota alejándose del cabezal 126 y se retrae de nuevo en el cabezal 126 para crear una superficie plana. En una realización, el actuador 34 incluye un mecanismo 150 conectado entre el mango 24 y la puerta 128 que incluye una varilla 152, con un extremo proximal 154 conectado a un mando 156 y un extremo distal 158 acoplado a la puerta 128. En una realización, el extremo proximal 154 está roscado de modo que proporcione un tornillo sin fin que engrana/se rosca con los filetes de rosca formados en el interior del mando 156. El mando 156 se fija al mango 24 mediante una pestaña 160 que permite que el mando 156 rote sin cambiar su posición longitudinal. De esta manera, la rotación del mando 156 se traduce en un movimiento longitudinal axial de la varilla 152 que realiza la función de mover la puerta 128 con relación al cabezal
126.
En una realización, el cabezal 126 es un cabezal con contrapeso e incluye un inserto pesado 170. El inserto pesado 170 se proporciona para desplazar un centro de gravedad del manipulador 100 hacia el cabezal 126. Por ejemplo, en una realización, el manipulador 100 tiene una longitud del dispositivo D, que se extiende desde un extremo proximal 172 del mango 24 hasta un extremo distal 174 del cabezal 126. Un punto medio M del manipulador 100 está ubicado en la mitad de la longitud del dispositivo D. El inserto pesado 170 desplaza una ubicación de un centro de gravedad Cg del manipulador 100 a una ubicación entre el punto medio M y el cabezal 126. De esta manera, el manipulador 100 tiene un “contrapesado delantero” hacia el cabezal 126, y esto facilita que el cabezal 126 permanezca situado dentro de la vagina sin que el asistente quirúrgico tenga que sujetar el mango 24. En una realización, el inserto pesado 170 se selecciona de modo que desplace el centro de gravedad Cg del manipulador 100 más cerca del cabezal 126 de lo que el centro de gravedad Cg está del punto medio M.
En una realización, el cabezal 126 está provisto de un recubrimiento lubricante 180 que permite al cabezal 126 tener una menor fricción para su colocación en la vagina. En una realización, el prolongador del cabezal 130 está provisto de un recubrimiento lubricante 182 que permite que el prolongador del cabezal 130 tenga una menor fricción para su colocación en la vagina. Un recubrimiento lubricante adecuado es un recubrimiento hidrófilo para su utilización como recubrimientos 180, 182 y se comercializa como recubrimiento hidrófilo avanzado HARMONYTM comercializado por SurModics, Inc., Eden Prairie, MN.
Aunque no se ilustra, las realizaciones del manipulador 100 incluyen proporcionar el indicador de tejido 400 deslizante, descrito anteriormente, al cabezal 126.
Las figuras 12-17 son vistas esquemáticas del dispositivo 20 empleado para manipular internamente una orientación de la vagina V del paciente durante un procedimiento laparoscópico. Las figuras 12-17 representan cierta anatomía relacionada pero no están dibujadas a escala. El procedimiento laparoscópico puede ser un procedimiento laparoscópico de tipo asistido robóticamente. El dispositivo es adecuado para su utilización manual en la disección de tejidos de la vagina V y en la manipulación de la orientación de la vagina V. Aunque las características de un procedimiento laparoscópico vaginal se describen a continuación, se debe sobreentender que el dispositivo 20 es adecuado para manipular de manera manual la vagina u otros órganos en otros procedimientos quirúrgicos, que incluyen otros procedimientos robóticos y similares.
La figura 12 es una vista esquemática de los órganos internos de un paciente en posición supina con el cabezal 26 del dispositivo 20 en posición para su introducción en la vagina V. Una vagina natural tiene una entrada y termina en el cuello del útero, que se comunica con el útero. A algunas mujeres se les han extirpado sus úteros mediante una histerectomía, y algunos de estos procedimientos dan como resultado la presencia de un muñón del cuello del útero CS conectado a la vagina V tal como se ilustra. El prolongador del cabezal 30 se configura de modo que acomode la presencia del cuello del útero o del muñón del cuello del útero CS.
La vejiga B se comunica con la uretra U y está ubicada de manera anterior con respecto a la vagina V y de manera posterior con respecto al hueso púbico PB. El tracto digestivo y el recto están ubicados de manera posterior con respecto a la vagina V. El sacro S y el coxis C están ubicados de manera posterior con respecto al tracto digestivo. La pared abdominal AB protege y soporta los órganos internos.
Durante un procedimiento quirúrgico laparoscópico, se realizan uno o más orificios de acceso a través de la pared abdominal AB (soportados generalmente mediante un trocar) para facilitar el acceso de una cámara de visualización y de los instrumentos a los órganos internos. En la realización ilustrada, un primer trocar 210 proporciona un orificio de acceso para los instrumentos quirúrgicos y un segundo trocar 212 proporciona un orificio de acceso para una cámara óptica 214. Se pueden realizar uno o más orificios adicionales (por ejemplo, un orificio de inflado con nitrógeno) a través de la pared abdominal AB, en lo que se describe tradicionalmente como un acercamiento transabdominal a la vagina V.
La figura 13 es una vista esquemática del cabezal 26 del dispositivo 20 insertado en la vagina V. El eje 22 se puede dirigir para facilitar al cirujano la manipulación del cabezal 26/prolongador 30 y controlar la orientación de la vagina V, lo cual es útil cuando se diseccionan tejidos de la vagina (figura 12) y cuando se acopla material de soporte a la vagina
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Claims (1)

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ES13173373.5T 2012-08-16 2013-06-24 Cabezal de manipulación vaginal con indicador de tejido y prolongador del cabezal Active ES2660421T3 (es)

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
DKPA201200506 2012-08-16
DK201200506 2012-08-16
US201261684822P 2012-08-20 2012-08-20
US201261684822P 2012-08-20
US201313772378 2013-02-21
US13/772,378 US8690893B2 (en) 2012-08-16 2013-02-21 Vaginal manipulator head with tissue index and head extender

Publications (1)

Publication Number Publication Date
ES2660421T3 true ES2660421T3 (es) 2018-03-22

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US (3) US8690893B2 (es)
EP (1) EP2698120B1 (es)
ES (1) ES2660421T3 (es)

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US9820772B2 (en) 2017-11-21
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