JP2001517104A - 最小侵入外科手術用のシステム、方法、機器 - Google Patents
最小侵入外科手術用のシステム、方法、機器Info
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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
- A61B17/34—Trocars; Puncturing needles
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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
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3209—Incision instruments
- A61B17/3211—Surgical scalpels, knives; Accessories therefor
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3415—Trocars; Puncturing needles for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00265—Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00345—Micromachines, nanomachines, microsystems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00362—Packages or dispensers for MIS instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2905—Details of shaft flexible
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B2017/3419—Sealing means between cannula and body
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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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1. 最小侵入性小型手術用機器であって、 末端部および基部を有する細長い本体と、 本体の末端部に接続される手術用器具と、 本体の基部に接続される検索部品と、 からなり、前記機器は15mm未満の外径を有することを特徴とする機器。 2. 検索部品は、綱を受け止めるように設計されていることを特徴とする請求の 範囲第1項記載の機器。 3. 検索部品は小孔であることを特徴とする請求の範囲第1項記載の機器。 4. 検索部品に固定された綱を更に有することを特徴とする請求の範囲第1項記 載の機器。 5. 綱は導電体からなり、手術用器具は電気メスからなることを特徴とする請求 の範囲第4項記載の機器。 6. 手術用はさみの形状であって、 本体は、末端部および基部を有する1対の頑丈なアームからなり、前記アーム はその基部で接続され、手術用器具は、各々がアームの一方の末端部にしっかり と固定されてのカッティングブレードを有することを特徴とする請求の範囲第1 項記載の機器。 7. 手術用把持器の形状であって、 本体は、末端部および基部を有する1対の堅固なアーム を有し、前記アームはその基部で接続され、手術用器具は、各々がアームの一方 の末端部にしっかりと固定されている1対の把持先端部を有することを特徴とす る請求の範囲第1項記載の機器。 8. 手術用器具はメスのブレードであり、 本体は、 メスのブレードを収容するように設計されている中空の開口部と、 本体の中空の開口部に対してメスのブレードを移動させてメスのブレードを 突出した展開状態と引っ込んだ閉じた状態との間で動かすように配置されたアク チュエータ機構とからなることを特徴とする請求の範囲第1項記載の機器。 9. 本体の基部近傍に配置された作動素子を更に有し、 作動素子の一部が本体に対して移動可能で器具と接触することを特徴とする請 求の範囲第1項記載の機器。 10. 作動素子は可撓性を呈し、作動素子は、細長い本体の長軸を包囲する可撓 性を呈する中空の球を有することを特徴とする請求の範囲第9項記載の機器。 11. 前記器具は、球がアームとほぼ垂直に圧縮されるときに互いに接触するよ うに構成された1対の平行なアームを有することを特徴とする請求の範囲第10 項記載の機器。 12. アームの1つは、アームの中間部に位置する最大値まで円滑に増加する外 径を有し、作動素子は、本体に固定さ れた基部と、器具の中間の直径に合う大きさを有する可動末端部リングとを有し 、前記球は基部を末端部リングに接続し、アームに対して実質的に垂直に圧縮さ れるとき、リングを1のアームの外面に沿って最大直径に向けて押しこみ、一緒 にアームを押し込むことを特徴とする請求の範囲第11項記載の機器。 13. 前記球は、生きている蝶番として機能する複数のスリットを有することを 特徴とする請求の範囲第12項記載の機器。 14. 前記球は、弾性を呈するプラスチック材料から作製されることを特徴とす る請求の範囲第10項記載の機器。 15. 前記機器は、長さが約5.08cm(2インチ)および15.24cm(6 インチ)との間にあることを特徴とする請求の範囲第9項記載の機器。 16. 手術用器具は、本体に接続されて実質的に平行な1対のアームから成る電 気メス機器であり、少なくとも1つのアームは、金属シムを包囲する絶縁性のオ ーバモールドと、シムの導電面を露出する内面とを有し、シムは、電気コードに 接続されるように構成されていることを特徴とする請求の範囲第1項記載の機器 。 17. 前記シムは、実質的に平らな基部と、実質的に平らな末端部と、前記基部 及び前記末端部に一緒に接続された折曲部とを有し、末端部は、導電面を含むこ とを特徴とする請求の範囲第16項記載の機器。 18. 前記オーバモールドは、シムの少なくとも1つの孔を経て突出して、前記 オーバモールド内でシムを固定することを特徴とする請求の範囲第16項記載の 機器。 19. 前記検索部品に接続された電気コードを更に有することを特徴とする請求 の範囲第16項記載の機器。 20. 第2のシムと第2の導電面とを他方のアームに更に有し、二極式の電気メス 機器を形成することを特徴とする請求の範囲第16項記載の機器。 21. 小型手術用機器を収容するように構成された中空の本体と、前記機器に接 続された綱とから成っているカニューレと、 中空のカニューレ本体の基部と係合するような大きさを有するとともに綱を収 容するために内部を通過する導管を有するプランジャと、 からなることを特徴とする小型手術用カニューレシステム。 22. プランジャが中空のカニューレ本体の基部と係合するときに、導管は中空 のカニューレ本体の内部と連通することを特徴とする請求の範囲第21項記載の システム。 23. 中空のカニューレ本体の内面とプランジャの外面とに接触して前記プラン ジャと前記カニューレとの間を気密に封止する封止リングを更に有することを特 徴とする請求の範囲第21項記載のシステム。 24. 中空のカニューレ本体は、本体の内面に溝及び突起部のうちの一方を有し 、プランジャは、プランジャの外面に 溝及び突起部のうちの他方を有し、前記溝および突起部は互いに係合するように 形成されて、カニューレ内でプランジャをロックすることを特徴とする請求の範 囲第21項記載のシステム。 25. 溝が、本体の内面にあり、突起部は、プランジャの外面にあることを特徴 とする請求の範囲第24項記載のシステム。 26. プランジャおよびカニューレは、互いに着脱自在にロックされように構成 されていることを特徴とする請求の範囲第21項記載のシステム。 27. カニューレ本体の末端部の外面は、カニューレを開口部へと螺合せしめて 体腔に係合させる螺旋形の突起部を含むことを特徴とする請求の範囲第21項記 載のシステム。 28. 綱を更に有することを特徴とする請求の範囲第21項記載のシステム。 29. カニューレは、気体吸入ポートを含むことを特徴とする請求の範囲第21 項記載のシステム。 30. 小型手術用機器に連結する綱と、 カニューレの内壁にはめ込まれて封止されるとともに、綱を収容する大きさを 有して内部に通過される導管を有するように構成されたプランジャと、 を有することを特徴とする手術用カニューレ封止システム。 31. プランジャは、カニューレの中空の本体内に部分的に収納可能とする大き さを有することを特徴とする請求の範 囲第30項記載のシステム。 32. 導管内のプランジャに配置されてプランジャと綱との間を気密に封止する 封止リングを更に有することを特徴とする請求の範囲第21または第30のシス テム。 33. 前記プランジャは、管状末端部と、拡張された基部とを有することを特徴 とする請求の範囲第21項または第30項記載のシステム。 34. 管状部は、管状部の壁に開けられた少なくとも1つの孔から成ることを特 徴とする請求の範囲第33項記載のシステム。 35. 綱は、電気コードであることを特徴とする請求の範囲第28項または第3 0項記載のシステム。 36. 前記機器を更に有することを特徴とする請求の範囲第28項または第30 項記載のシステム。 37. 綱は、前記機器に着脱自在に接続されることを特徴とする請求の範囲第3 6項記載のシステム。 38. 小型手術用機器を収容可能に構成された中空の円筒本体と、 本体の末端部に配置された第1のバルブと、 本体の基部に配置された第2のバルブと、 を有し、前記第1および第2のバルブは独立に操作され、前記バルブのうちの少 なくとも1つは、前記バルブを通過する手術用機器と接触して封止するように構 成された可撓性材料からなることを特徴とする手術用機器交換カニュー レ。 39. 第2のバルブは、小型手術用機器を挿入するために開放され、次に前記機 器がカニューレ本体から第1のバルブを経て除去される前に閉じられるフラップ ドアバルブであることを特徴とする請求の範囲第38項記載の機器交換カニュー レ。 40. 前記フラップドアバルブの開口部を通過してカニューレの本体内で摺動す るように構成されたプランジャを更に有し、プランジャは、ユーザがカニューレ 内に小型手術用機器を十分な距離だけ押し込んで、機器の末端部が第1のバルブ を通過してカニューレ本体の末端部から突出するような十分な長さを有すること を特徴とする請求の範囲第39項記載の機器交換カニューレ。 41. プランジャを伸長した不押圧状態に付勢するように構成されたバネを更に 含むことを特徴とする請求の範囲第40項記載の機器交換カニューレ。 42. 第1のバルブは、スプリットシールバルブであることを特徴とする請求の 範囲第38項記載の機器交換カニューレ。 43. 綱に対する取付点を更に有することを特徴とする請求の範囲第39項記載 の機器交換カニューレ。 44. 手術用機器交換カニューレと、ハンドアクセスポートと、小型手術用機器 とからなることを特徴とする最小侵入性手術システム。 45. 患者の体腔にて最小侵入性手術を処理する方法であって、 ハンドアクセスポート用に1次最小切開を行う行程と、 1次切開にハンドアクセスポートを配置する行程と、 ハンドアクセスポートを経て体腔に手を挿入する行程と、 小型手術用機器交換カニューレ用に少なくとも1つの2次最小切開を行う行程 と、 2次切開に機器交換カニューレを挿入する行程と、 体腔に機器交換カニューレを介して第1の小型手術用機器を挿入する行程と、 体腔内で手で手術用機器を操って最小侵入性手術を実行する行程と、からなる ことを特徴とする方法。 46. 2次切開が行われたあと手は体腔に挿入されることを特徴とする請求の範 囲第45項記載の方法。 47. 体腔から第1の小型手術用機器を除去する行程と、機器交換カニューレを 経て第2の小型手術用機器を挿入する行程とを更に有することを特徴とする請求 の範囲第45項記載の方法。 48. 更なる行程は、体腔から手を抜かずに実行されることを特徴とする請求の 範囲第47項記載の方法。 49. 手術用機器は、体腔内で手で操られて動かされることを特徴とする請求の 範囲第45項記載の方法。 50. 手術用機器は、体腔内で操られて、体腔の外側から動かされることを特徴 とする請求の範囲第45項記載の方法。 51. 小型手術用機器は、把持器、または、はさみ、持針器、クリップ供給器、 解剖器具、切除器、メス、電気メス、ガーゼパッドであることを特徴とする請求 の範囲第45項記載の方法。 52. 体腔は気体が注入され、腹膜腔吹入膨張はプロシージャの全体にわたって 維持されることを特徴とする請求の範囲第45項記載の方法。 53. 機器交換カニューレ内で小型手術用機器を一時的に格納する行程と、 次にカニューレから機器を除去して再び機器を使用する行程と、 を更に有することを特徴とする請求の範囲第45項記載の方法。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US75216796A | 1996-11-18 | 1996-11-18 | |
US08/752,167 | 1996-11-18 | ||
US08/946,500 | 1997-10-07 | ||
US08/946,500 US6165184A (en) | 1996-11-18 | 1997-10-07 | Systems methods and instruments for minimally invasive surgery |
PCT/US1997/020514 WO1998022030A1 (en) | 1996-11-18 | 1997-11-05 | Systems, methods, and instruments for minimally invasive surgery |
Publications (2)
Publication Number | Publication Date |
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JP2001517104A true JP2001517104A (ja) | 2001-10-02 |
JP4049275B2 JP4049275B2 (ja) | 2008-02-20 |
Family
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP52371698A Expired - Fee Related JP4049275B2 (ja) | 1996-11-18 | 1997-11-05 | 最小侵入外科手術用のシステム、方法、機器 |
Country Status (10)
Country | Link |
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US (1) | US6159200A (ja) |
EP (1) | EP1006888B1 (ja) |
JP (1) | JP4049275B2 (ja) |
AT (1) | ATE320217T1 (ja) |
AU (1) | AU742708B2 (ja) |
BR (1) | BR9714740A (ja) |
CA (1) | CA2271029C (ja) |
DE (1) | DE69735501T2 (ja) |
ES (1) | ES2264172T3 (ja) |
WO (1) | WO1998022030A1 (ja) |
Cited By (1)
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JP2011189119A (ja) * | 2010-03-12 | 2011-09-29 | Microline Surgical Inc | ピクチャーインピクチャークリップ供給ビデオシステム |
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US6436107B1 (en) * | 1996-02-20 | 2002-08-20 | Computer Motion, Inc. | Method and apparatus for performing minimally invasive surgical procedures |
US6549800B1 (en) * | 1996-04-25 | 2003-04-15 | Johns Hopkins Unversity School Of Medicine | Methods for in vivo magnetic resonance imaging |
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JP2011189119A (ja) * | 2010-03-12 | 2011-09-29 | Microline Surgical Inc | ピクチャーインピクチャークリップ供給ビデオシステム |
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EP1006888A4 (en) | 2000-06-14 |
AU5200398A (en) | 1998-06-10 |
EP1006888A1 (en) | 2000-06-14 |
EP1006888B1 (en) | 2006-03-15 |
DE69735501D1 (de) | 2006-05-11 |
CA2271029C (en) | 2006-01-10 |
US6159200A (en) | 2000-12-12 |
WO1998022030A1 (en) | 1998-05-28 |
AU742708B2 (en) | 2002-01-10 |
CA2271029A1 (en) | 1998-05-28 |
JP4049275B2 (ja) | 2008-02-20 |
ATE320217T1 (de) | 2006-04-15 |
ES2264172T3 (es) | 2006-12-16 |
DE69735501T2 (de) | 2006-12-14 |
BR9714740A (pt) | 2002-01-02 |
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