ES2660481T3 - Aparato para corte y sellado de tejido - Google Patents
Aparato para corte y sellado de tejido Download PDFInfo
- Publication number
- ES2660481T3 ES2660481T3 ES15183442.1T ES15183442T ES2660481T3 ES 2660481 T3 ES2660481 T3 ES 2660481T3 ES 15183442 T ES15183442 T ES 15183442T ES 2660481 T3 ES2660481 T3 ES 2660481T3
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- Spain
- Prior art keywords
- jaws
- indexing
- articulation
- jaw
- articulator
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
- A61B2018/00202—Moving parts rotating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00297—Means for providing haptic feedback
- A61B2018/00309—Means for providing haptic feedback passive, e.g. palpable click when activating a button
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/0063—Sealing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
- A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation
Abstract
Un dispositivo electroquirúrgico (100) para cortar y sellar tejido comprendiendo una mordaza superior (120) situada en un extremo distal del dispositivo electroquirúrgico (100) y opuesta a una mordaza inferior (132), estando la mordaza inferior (132) conectada de manera pivotante a la mordaza superior (120) mediante una conexión (140) de pivote, y un mecanismo (200) de articulación para controlar el movimiento de flexión o de giro de las mordazas superior e inferior (120, 132), en el que el mecanismo (200) de articulación comprende una carcasa (230) y un disco de indexación (210) dispuesto que puede desplazarse de manera giratoria en la carcasa (230), en el que la carcasa (230) comprende una pluralidad de muescas (234) de trinquete y el disco de indexación (210) comprende un brazo (212) de indexación para enganchar las muescas (234) de trinquete para indexar la posición de las mordazas superior e inferior (120, 132), caracterizado por que el mecanismo (200) de articulación además comprende un mecanismo (250) de bloqueo automático, en el que el mecanismo (250) de bloqueo automático es un mecanismo de interconexión pasiva que impide que una fuerza externa sobre las mordazas superior e inferior (120, 132) mueva las mordazas superior e inferior (120, 132) fuera de una posición indexada.
Description
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un par de resortes 216 de lámina flexible, que se extienden desde cada disco 210 de indexación. Cada resorte 216 de lámina tiene un extremo distal 217 que se mantiene en una posición cautiva entre un par de salientes 226 en el articulador 220. Cuando el articulador 220 está en la condición neutral, cada resorte 216 de lámina está sustancialmente recto, en un estado relajado. Cuando el articulador 220 comienza a girar a la izquierda o a la derecha, los salientes 226 también giran, pero los discos 210 de indexación no giran inmediatamente y, en su lugar, permanecen estacionarios, como se explicará en más detalle a continuación. Como tal, cada resorte 216 de lámina se dobla en respuesta al movimiento inicial de los salientes 226, almacenando energía en el resorte de lámina que crea una fuerza de desviación. La fuerza de desviación de cada resorte 216 de lámina aplica una fuerza al articulador 220 en la dirección opuesta a la dirección en la que se giró el articulador, para empujar el articulador de vuelta hacia la condición neutral. Cuando se libera la fuerza de rotación desde el articulador 200, la fuerza de desviación de los resortes 216 de lámina hacer volver el articulador 200 de nuevo a la condición neutral.
El mecanismo 200 de articulación incluye además un mecanismo 250 de bloqueo automático. El mecanismo 250 de bloqueo es un mecanismo de interbloqueo pasivo, que impide que una fuerza externa sobre las mordazas superior e inferior 120 y 132 mueva las mordazas fuera de su posición indexada. El mecanismo 250 de bloqueo incluye cuatro retenes 228 en el articulador 220, dos de los cuales son visibles en las Figuras, y dos de los cuales están en el lado opuesto del articulador. Cada retén 228 es móvil con respecto a los discos 210 de indexación, entre una posición de bloqueo y una posición de liberación. En la posición de bloqueo, mostrada en la Figura 9, cada retén 228 está alineado con un saliente interior 219 en uno de los brazos 212 de indexación. En esta posición, los salientes interiores 219 bloquean los brazos de indexación y evitan que se doblen hacia el interior, evitando por ello que los brazos de indexación se desenganchen de las muescas de trinquete, e impidan la articulación de las mordazas desde su posición indexada. En la posición de liberación, mostrada en la Figura 10, cada retén 228 está girado fuera de alineación con el correspondiente saliente interior 219, permitiendo que los brazos de indexación se doblen hacia dentro y desenganchen las muescas de trinquete para facilitar la articulación de las mordazas a otra posición.
En esta disposición, el mecanismo 200 de articulación es un mecanismo flotante que se desvía hacia la condición neutral con respecto a los discos de indexación. En funcionamiento, las mordazas se articulan girando el articulador 220 ya sea en sentido horario o antihorario, con respecto a la carcasa 230, a través de los agarraderos 222. Cuando se aplica inicialmente una fuerza de rotación a los agarraderos 222, la fuerza aplicada se opone por las fuerzas de centrado de los resortes 216 de lámina. Si la fuerza aplicada es mayor que las fuerzas de centrado, el articulador 220 girará con respecto a los discos 210 de indexación, de modo que los retenes 228 se mueven fuera de la posición de bloqueo hasta la posición de liberación.
El articulador 220 tiene cuatro bordes de apoyo 225, y los discos 210 de indexación tienen unos correspondientes bordes de apoyo 211. Cuando el articulador está en la condición neutral, los bordes de apoyo 211 están separados de los bordes de apoyo 225, creando unos pequeños huecos 229 que definen los límites del recorrido. Tras la rotación inicial de los agarraderos 222, el articulador 220 girará, y dos de los bordes de apoyo 225 se aproximarán a los correspondientes bordes de apoyo 211 de los discos 210 de indexación. Después de que se giran los agarraderos 222 a través de un pequeño ángulo umbral de rotación, tal como 5 grados, los bordes de apoyo 225 que se acercan a los bordes de apoyo 211 de los discos 210 de indexación alcanzarán su límite de recorrido y harán contacto con los discos 210 de indexación. En este punto, la fuerza de rotación aplicada a los agarraderos se transferirá a los discos 210 de indexación y girará los discos de indexación en tándem con el articulador 220. A medida que giren los discos de indexación 210, las puntas 215 de los brazos 212 de indexación se doblan hacia dentro, a medida que se enganchan de manera deslizante con los dientes 235 de trinquete y se encajarán por presión hacia el exterior a medida que se alineen con las muescas 234 de trinquete, en la siguiente posición indexada. Al alcanzar una posición indexada deseada, se libera una fuerza de rotación de los agarraderos 222, de modo que los resortes 216 de lámina devolverán el articulador 220 a la condición neutral, con los retenes 228 devueltos a la posición de bloqueo. En la posición de bloqueo, los retenes 228 impiden que los brazos 212 de indexación se desenganchen de las muescas 234 de trinquete, bloqueando de manera efectiva los cables 172 y 174 de articulación y la muñeca 170 en la posición indizada.
Con referencia a las Figuras 11 y 12, el dispositivo 100 incluye una placa 260 de resorte que está unida a los extremos proximales de los cables 172 y 174 de articulación. La placa 260 de resorte pone en tensión los cables 172 y 174 de articulación para asegurar entre sí los componentes de la muñeca 170, evitando por ello la necesidad de utilizar otros medios para unir físicamente los componentes de la muñeca. Los discos 210 de indexación sujetan la placa 260 de resorte en su sitio, en la carcasa 230. Cada cable 172 y 174 de articulación se extiende a través de un orificio en una porción 262 de ala de la placa 260 de resorte. El extremo proximal de cada cable 172 y 174 de articulación se dobla y captura en un obturador 270 de cable. Cada obturador 270 de cable está enchavetado para mantener su orientación contra la placa 260 de resorte. Cada porción 262 de ala tiene un estado relajado, en el que la porción de ala se dobla en una dirección proximal con respecto al resto de la placa 260 de resorte. En el estado montado, los obturadores 270 de cable se arrastran distalmente contra las porciones 262 de ala para tensar el mecanismo 200 de articulación.
Mecanismo de muñeca
Las realizaciones pueden incluir un mecanismo de muñeca con componentes que tengan interfaces de pivote “no circulares”. Por ejemplo, las interfaces de pivote entre los componentes pueden tener geometrías parabólicas,
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escalonadas o con muescas en V, dando como resultado un eje móvil de rotación en lugar de un eje fijo de rotación tradicional asociado con las geometrías estrictamente “circulares”, tales como las geometrías de interconexión esféricas o cilíndricas. El eje móvil de rotación proporciona el beneficio de un acoplamiento de enderezamiento automático o de centrado automático, en el que las vértebras colindantes se empujan a regresar a una configuración recta después de ser articuladas. Esta desviación hacia una configuración enderezada estabiliza la posición de las mordazas y proporciona resistencia contra las oscilaciones cuando las mordazas se bloquean o entran en contacto con otros objetos.
La interfaz no circular también resiste la perdida de la fuerza de compresión experimentada por las mordazas, cuando se articulan las mordazas mediante el alargamiento de la longitud eficaz del eje. En los dispositivos que tienen un mecanismo de tipo “tracción” para cerrar las mordazas, el alargamiento del eje (sin cambios en el mecanismo de bloqueo de mordazas) dará como resultado tirar más fuerte para más fuerza de compresión.
La Figura 13 muestra un ejemplo de una interfaz no circular 171 entre la vértebra 173 y un casquillo 182, en la sección 170 de muñeca. La interfaz no circular 171 incluye una superficie 175 de acoplamiento convexa redondeada sobre la vértebra 173, y una superficie 184 de acoplamiento cóncava redondeada sobre el casquillo 182. Un escalón u “lóbulo” 177 se extiende hacia fuera desde la superficie 175 de acoplamiento convexa. Las transiciones superficiales entre el lóbulo 177 y la superficie 175 de acoplamiento convexa son redondeadas, formando una curvatura compuesta lisa a lo largo del borde de la vértebra 173. Un rebaje 185 se extiende hacia la superficie 184 de acoplamiento cóncava y tiene una forma que se adapta a la geometría del lóbulo 177, como se muestra.
Cuando la sección 170 de muñeca es recta (es decir, cuando las vértebras no están articuladas y las mordazas están rectas), la superficie 175 de acoplamiento convexa y el lóbulo 177 están en fase con la superficie 184 de acoplamiento cóncava y el rebaje 185, estando el lóbulo anidado en el rebaje. Cuando se articula la sección 170 de muñeca, la superficie 175 de acoplamiento convexa y el lóbulo 177 se desplazan fuera de fase con la superficie 184 de acoplamiento cóncava y el rebaje 185, de manera que el lóbulo se mueva fuera del rebaje y enganche con la superficie de acoplamiento cóncava. En esta condición, la distancia entre la vértebra 173 y el casquillo 182 aumenta de forma incremental, desplazando el eje de rotación entre las partes. La dimensión del lóbulo 177 puede ser muy pequeña con relación al tamaño de la superficie 175 de acoplamiento convexa. El perímetro redondeado del lóbulo 177 puede sobresalir una distancia tan pequeña como 0,0508 mm (0,002 pulgadas) de la superficie 175 de acoplamiento convexa. También pueden utilizarse configuraciones de lóbulo más pequeñas o más grandes.
Aunque las realizaciones de la invención se han mostrado y descrito en la presente memoria, se comprenderá que tales realizaciones se proporcionan solamente a modo de ejemplo. Los expertos en la técnica podrán pensar en numerosas variaciones, cambios y sustituciones, sin apartarse de la invención. En consecuencia, se pretende que las reivindicaciones adjuntas cubran todas las de tales variaciones en la medida que caigan dentro del alcance de la invención.
Compendio de aspectos de la presente invención
1. Un dispositivo electroquirúrgico para cortar y sellar tejido, comprendiendo el dispositivo electroquirúrgico:
una mordaza superior situada en un extremo distal del dispositivo electroquirúrgico y opuesta a una mordaza inferior, la mordaza inferior conectada de manera pivotante a la mordaza superior mediante una conexión de pivote,
en el que la conexión de pivote comprende un paso que contiene una porción de la mordaza superior, pudiendo desplazarse la mordaza superior axialmente a través del paso para pivotar la mordaza superior con respecto a la mordaza inferior entre una condición relativamente abierta y una condición relativamente cerrada, pudiendo operarse la mordaza superior y la mordaza inferior en la condición relativamente cerrada para suministrar energía de RF al tejido.
- 2.
- El dispositivo electroquirúrgico del aspecto 1, en el que la mordaza superior puede pivotar con respecto a la mordaza inferior alrededor de un punto de pivote situado adyacente a un borde exterior de la mordaza superior, estando desplazado el punto de pivote de una línea central del dispositivo.
- 3.
- El dispositivo electroquirúrgico del aspecto 1, en el que la conexión de pivote comprende un elemento semicilíndrico que tiene una superficie convexa que engancha con un primer lado de la mordaza superior.
- 4.
- El dispositivo electroquirúrgico del aspecto 3, en el que la conexión de pivote comprende además una superficie cóncava que se engancha con un segundo lado de la mordaza superior.
- 5.
- El dispositivo electroquirúrgico del aspecto 4, en el que la superficie convexa y la superficie cóncava definen paredes opuestas del paso.
- 6.
- El dispositivo electroquirúrgico del aspecto 4, en el que la superficie convexa y la superficie cóncava siguen perfiles circulares que son concéntricos alrededor de un punto común.
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Claims (1)
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imagen1
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261705721P | 2012-09-26 | 2012-09-26 | |
US201261705721P | 2012-09-26 |
Publications (1)
Publication Number | Publication Date |
---|---|
ES2660481T3 true ES2660481T3 (es) | 2018-03-22 |
Family
ID=49681068
Family Applications (4)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES13798723.6T Active ES2628297T3 (es) | 2012-09-26 | 2013-09-26 | Aparato de corte y sellado de tejido |
ES15183441.3T Active ES2628848T3 (es) | 2012-09-26 | 2013-09-26 | Aparato de corte y sellado de tejido |
ES15183443.9T Active ES2660397T3 (es) | 2012-09-26 | 2013-09-26 | Aparato para corte y sellado de tejido |
ES15183442.1T Active ES2660481T3 (es) | 2012-09-26 | 2013-09-26 | Aparato para corte y sellado de tejido |
Family Applications Before (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES13798723.6T Active ES2628297T3 (es) | 2012-09-26 | 2013-09-26 | Aparato de corte y sellado de tejido |
ES15183441.3T Active ES2628848T3 (es) | 2012-09-26 | 2013-09-26 | Aparato de corte y sellado de tejido |
ES15183443.9T Active ES2660397T3 (es) | 2012-09-26 | 2013-09-26 | Aparato para corte y sellado de tejido |
Country Status (8)
Country | Link |
---|---|
US (1) | US9872724B2 (es) |
EP (4) | EP2900162B1 (es) |
JP (4) | JP6336451B2 (es) |
KR (3) | KR102210195B1 (es) |
CN (3) | CN104768488B (es) |
BR (3) | BR112015006554B1 (es) |
ES (4) | ES2628297T3 (es) |
WO (1) | WO2014049423A1 (es) |
Families Citing this family (14)
Publication number | Priority date | Publication date | Assignee | Title |
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US9872724B2 (en) * | 2012-09-26 | 2018-01-23 | Aesculap Ag | Apparatus for tissue cutting and sealing |
CN107920853A (zh) * | 2015-08-05 | 2018-04-17 | 奥林巴斯株式会社 | 处置器具 |
US11076908B2 (en) * | 2016-06-02 | 2021-08-03 | Gyrus Acmi, Inc. | Two-stage electrosurgical device for vessel sealing |
US10149726B2 (en) * | 2016-07-01 | 2018-12-11 | Ethicon Endo-Surgery, Llc | Methods, systems, and devices for initializing a surgical tool |
KR20190119094A (ko) * | 2017-02-27 | 2019-10-21 | 아사히 인텍크 가부시키가이샤 | 매니퓰레이터 |
US10932845B2 (en) * | 2017-04-27 | 2021-03-02 | Ethicon Llc | Detent feature for articulation control in surgical instrument |
GB2565575A (en) * | 2017-08-17 | 2019-02-20 | Creo Medical Ltd | Electrosurgical apparatus for delivering RF and/or microwave energy into biological tissue |
CN108186081B (zh) * | 2017-12-18 | 2019-12-17 | 南京天朗制药有限公司 | 一种具有剪切功能的医院手术室用手术镊 |
USD904611S1 (en) | 2018-10-10 | 2020-12-08 | Bolder Surgical, Llc | Jaw design for a surgical instrument |
USD966513S1 (en) * | 2019-01-25 | 2022-10-11 | Karl Storz Se & Co. Kg | Shaft attachable medical instrument |
JP1650796S (es) * | 2019-01-25 | 2020-01-20 | ||
JP1650869S (es) * | 2019-01-25 | 2020-01-20 | ||
USD938588S1 (en) * | 2019-01-25 | 2021-12-14 | Karl Storz Se & Co. Kg | Shaft attachable medical instrument |
US11813017B2 (en) | 2019-03-11 | 2023-11-14 | Microline Surgical, Inc. | Reusable minimally invasive surgical instrument |
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