JP2004305741A - 組織の2つの層の間に吻合を形成するための器具、および手術用カッターに取り付け可能で切断されるべき組織に隣接して配置可能な器具 - Google Patents
組織の2つの層の間に吻合を形成するための器具、および手術用カッターに取り付け可能で切断されるべき組織に隣接して配置可能な器具 Download PDFInfo
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- 239000012636 effector Substances 0.000 claims abstract description 12
- 230000007246 mechanism Effects 0.000 claims description 5
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- 210000002784 stomach Anatomy 0.000 description 8
- 238000000034 method Methods 0.000 description 7
- 238000010304 firing Methods 0.000 description 6
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- 238000001356 surgical procedure Methods 0.000 description 5
- 230000001174 ascending effect Effects 0.000 description 3
- 210000001630 jejunum Anatomy 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 230000009471 action Effects 0.000 description 2
- 235000013351 cheese Nutrition 0.000 description 2
- 238000010276 construction Methods 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 235000013305 food Nutrition 0.000 description 2
- 230000003886 intestinal anastomosis Effects 0.000 description 2
- 201000003741 Gastrointestinal carcinoma Diseases 0.000 description 1
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- 230000015572 biosynthetic process Effects 0.000 description 1
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- 210000004369 blood Anatomy 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 238000002674 endoscopic surgery Methods 0.000 description 1
- 210000003238 esophagus Anatomy 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 201000002313 intestinal cancer Diseases 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
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- 235000015097 nutrients Nutrition 0.000 description 1
- 210000000056 organ Anatomy 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 210000000626 ureter Anatomy 0.000 description 1
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Classifications
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00685—Archimedes screw
-
- 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
- A61B2017/07285—Stapler heads characterised by its cutter
Abstract
【解決手段】 シャフト40と、シャフトの遠位の端部に取り付けられ第1の組織係合面16を有する第1の長寸のフォーク10と第2の組織係合面48を有する第2の長寸のフォーク21とを有すると共に少なくとも2つの間隔を置いて配置された組織固定具15の列50を長手方向の軸に実質的に平行に組織に取り付ける手段をさらに含むエンドエフェクタと、少なくとも2つの間隔を置いて配置された組織固定具の列の間を第1および第2の長寸のフォークの長手方向の軸とほぼ平行な方向に移動可能な切断用具18と、切断用具が組織固定具の列の近位の端部および遠位の端部の間のみを切るように切断用具を駆動するための手段12,26,28とを有する。
【選択図】 図2
Description
(1)切断用具を近位の組織端部から離れた点から始まる切断線に沿って案内できる上記第1の長寸のフォーク内の軌道をさらに有する、請求項1記載の器具。
(2)軌道が切断用具を組織係合面に向けて動かして上記切断用具を露出させる上り部分を有する、請求項1記載の器具。
(3)軌道が切断器具を組織係合面から離れるように動かして上記切断用具を隠す下り部分をさらに有する、上記実施態様(2)記載の器具。
(4)切断用具が柔軟な部分をさらに有し、上記柔軟な部分が曲がることによって上記切断用具の第1の部分が軌道に従うようにされる、請求項1記載の器具。
(5)切断用具が上記切断用具が露出されたときに組織係合面にほぼ垂直に突出する穿通先端をさらに有する、請求項1記載の器具。
(7)切断用具を駆動するための機構が、切断用具を組織係合面に向けて動かしそして上記組織係合面から離れるように動かすための軌道を有する、請求項2記載の器具。
(8)切断用具を駆動するための機構が、切断用具を組織係合面に向けて動かしそして上記組織係合面から離れるように動かすための軌道を有する、請求項2記載の器具。
(9)切断用具、軌道、および組織固定具が、器具から取り外し可能な自蔵式カートリッジ内に配置されている、請求項2記載の器具。
(10)切断用具が柔軟な部分をさらに有し、上記柔軟な部分が曲がることによって上記切断用具の第1の部分が軌道に従うようにされる、請求項2記載の器具。
(12)切断用具が上記切断用具の遠位の端部に沿って角度をなす切断面をさらに有する、上記実施態様(11)記載の器具。
(13)ハウジング内の複数のステープルをさらに有する、請求項3記載の器具。
(14)軌道が切断用具を組織面から離れるように動かして上記切断用具を隠す下り部分をさらに有する、請求項3記載の器具。
(15)切断用具の表面に配置されていて軌道に沿って移動可能なカムフォロアをさらに有する、請求項3記載の器具。
(16)切断用具が器具を通って動くナイフアクチエータによって遠位の向きに動かされ、
上記切断用具が柔軟な部分を有し、上記柔軟な部分が上記切断用具の第1の部分が上記切断用具のその他の部分が上記ナイフアクチエータと軸線方向で整合しながら上記軌道に従うようにする、請求項3記載の器具。
(17)切断用具が上記切断用具が組織面に向けて動かされるときに組織を突き刺すように配置されている穿通先端を有する、請求項3記載の器具。
(18)切断用具が上記切断用具の遠位の端部に沿って角度をなすように配置された切断エッジを有する、請求項3記載の器具。
11 リニアカッター
12 カム面
13 ステープルポケット
14 近位の部分
15 ステープル
16 ハウジング組織面
17 小さな開口
18 切断用具
20 上り傾斜部分
21 アンビル
22 下り傾斜部分
23 フレーム
24 中央カム部分
25 ハウジング
26 ナイフアクチエータ
27 閉鎖トリガ
28 カムフォロア
29 発射トリガ
30 ナイフ先端
31 近位の組織端部
32 スロット
33 ナイフエッジ
34 角度
35 切断されていない組織
36 通路
38 ナイフスロット
40 シャフト
42 シャフトの近位の端部
44 シャフトの遠位の端部
46 長手方向の軸
48 アンビル組織面
50 ステープル列
52 ステープル列の近位の端部
54 ステープル列の遠位の端部
Claims (3)
- 組織の2つの層の間に吻合を形成するための器具であって、
(a)近位の端部および遠位の端部を有するシャフトおよび上記シャフトの上記遠位の端部に取り付けられたエンドエフェクタであって、上記エンドエフェクタは近位の端部と、遠位の端部と、上記近位の端部および上記遠位の端部の間の長手方向の軸とを備えた第1の長寸のフォークおよび第2の長寸のフォークを有し、上記第1の長寸のフォークは第1の組織係合面を有し、上記第2の長寸のフォークは第2の組織係合面を有し、上記エンドエフェクタは、上記第1および第2の長寸のフォークの少なくとも上記遠位の端部が互いに離れて配置されている開いた位置と、上記第1および第2の組織係合面が密接に隣接する閉じた位置と有し、上記エンドエフェクタは少なくとも2つの間隔を置いて配置された組織固定具の列を上記長手方向の軸に実質的に平行に組織に取り付ける手段をさらに含む、上記シャフトおよびエンドエフェクタと、
(b)上記少なくとも2つの間隔を置いて配置された組織固定具の列の間を上記第1および第2の長寸のフォークの上記長手方向の軸とほぼ平行な方向に移動可能な切断用具と、
(c)上記切断用具が上記組織固定具の列の近位の端部および遠位の端部の間のみを切るように上記切断用具を駆動するための手段と
を有する、吻合を形成するための器具。 - 組織の2つの層の間に吻合を形成するための器具であって、
(a)近位の端部および遠位の端部を有するシャフトおよび上記シャフトの上記遠位の端部に取り付けられたエンドエフェクタであって、上記エンドエフェクタは近位の端部と、遠位の端部と、上記近位の端部および上記遠位の端部の間の長手方向の軸とを備えた2つの長寸のフォークを有し、上記長寸のフォークの各々は組織係合面を有し、上記エンドエフェクタは、上記長寸のフォークの少なくとも上記遠位の端部が互いに離れて配置されている開いた位置と、上記組織係合面が密接に隣接する閉じた位置と有し、上記エンドエフェクタは少なくとも2つの間隔を置いて配置された組織固定具の列を上記長手方向の軸に実質的に平行に組織に取り付ける手段をさらに含む、上記シャフトおよびエンドエフェクタと、
(b)上記少なくとも2つの間隔を置いて配置された組織固定具の列の間を上記2つの長寸のフォークの上記長手方向の軸とほぼ平行な方向に移動可能な切断用具と、
(c)上記切断用具が上記組織固定具の列の近位の端部および遠位の端部の間のみを切るように上記切断用具を駆動するための機構と
を有する、吻合を形成するための器具。 - 手術用カッターに取り付け可能で切断されるべき組織に隣接して配置可能な器具であって、
(a)組織面を有するハウジングと、
(b)上記ハウジング内に配置されていて上記組織面にほぼ平行な方向に移動可能な切断用具と、
(c)上記切断用具に隣接して配置されていて、上記切断用具を上記組織面に向けて動かして上記切断用具を露出させる上りカム部分を有する軌道と
を有する、手術用カッターに取り付け可能で切断されるべき組織に隣接して配置可能な器具。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/405,684 US20040199181A1 (en) | 2003-04-02 | 2003-04-02 | Surgical device for anastomosis |
Publications (2)
Publication Number | Publication Date |
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JP2004305741A true JP2004305741A (ja) | 2004-11-04 |
JP4672276B2 JP4672276B2 (ja) | 2011-04-20 |
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JP2004109203A Expired - Fee Related JP4672276B2 (ja) | 2003-04-02 | 2004-04-01 | 組織の2つの層の間に吻合を形成するための器具、および手術用カッターに取り付け可能で切断されるべき組織に隣接して配置可能な器具 |
Country Status (7)
Country | Link |
---|---|
US (1) | US20040199181A1 (ja) |
EP (1) | EP1464287B1 (ja) |
JP (1) | JP4672276B2 (ja) |
AT (1) | ATE453365T1 (ja) |
AU (2) | AU2004201380A1 (ja) |
DE (1) | DE602004024843D1 (ja) |
MX (1) | MXPA04003214A (ja) |
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JP2002516147A (ja) * | 1998-05-22 | 2002-06-04 | スペシャライズド・ヘルス・プロダクツ・インコーポレーテッド | ランセット装置および方法 |
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US5489058A (en) * | 1994-05-02 | 1996-02-06 | Minnesota Mining And Manufacturing Company | Surgical stapler with mechanisms for reducing the firing force |
US5632432A (en) * | 1994-12-19 | 1997-05-27 | Ethicon Endo-Surgery, Inc. | Surgical instrument |
US6109500A (en) * | 1996-10-04 | 2000-08-29 | United States Surgical Corporation | Lockout mechanism for a surgical stapler |
US6066144A (en) * | 1997-10-07 | 2000-05-23 | Ethicon Endo-Surgery, Inc. | Surgical anastomosis method |
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2003
- 2003-04-02 US US10/405,684 patent/US20040199181A1/en not_active Abandoned
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2004
- 2004-04-01 AU AU2004201380A patent/AU2004201380A1/en not_active Abandoned
- 2004-04-01 JP JP2004109203A patent/JP4672276B2/ja not_active Expired - Fee Related
- 2004-04-02 AT AT04252018T patent/ATE453365T1/de not_active IP Right Cessation
- 2004-04-02 EP EP04252018A patent/EP1464287B1/en not_active Expired - Lifetime
- 2004-04-02 MX MXPA04003214A patent/MXPA04003214A/es unknown
- 2004-04-02 DE DE602004024843T patent/DE602004024843D1/de not_active Expired - Lifetime
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2011
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JPS5697442A (en) * | 1979-12-20 | 1981-08-06 | Vnii Ispytatel Med Tech | Surgical operation instrument for suturing hollow organ |
US4397311A (en) * | 1979-12-20 | 1983-08-09 | Vesesojuzny Nauchnoissledovatelsky I Ispytatelny Institut | Surgical instrument for staple suturing of hollow organs |
JP2002516147A (ja) * | 1998-05-22 | 2002-06-04 | スペシャライズド・ヘルス・プロダクツ・インコーポレーテッド | ランセット装置および方法 |
Cited By (20)
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JP2010240419A (ja) * | 2009-04-01 | 2010-10-28 | Ethicon Endo Surgery Inc | 組織を切断し締結するための方法及びデバイス |
US9924941B2 (en) | 2011-10-26 | 2018-03-27 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
US11564681B2 (en) | 2011-10-26 | 2023-01-31 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
US10912556B2 (en) | 2011-10-26 | 2021-02-09 | Intuitive Surgical Operations, Inc. | Surgical instrument with integral knife blade |
KR102008221B1 (ko) | 2011-11-15 | 2019-08-07 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
KR20200055144A (ko) * | 2011-11-15 | 2020-05-20 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
US9757125B2 (en) | 2011-11-15 | 2017-09-12 | Intuitive Surgical Operations, Inc. | Surgical instrument with stowing knife blade |
KR20140093996A (ko) * | 2011-11-15 | 2014-07-29 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
US11350933B2 (en) | 2011-11-15 | 2022-06-07 | Intuitive Surigical Operations, Inc. | Surgical instrument with stowing knife blade |
JP2019048153A (ja) * | 2011-11-15 | 2019-03-28 | インテュイティブ サージカル オペレーションズ, イン | しまい込めるナイフブレードを持つ手術器具 |
JP2015504334A (ja) * | 2011-11-15 | 2015-02-12 | インテュイティブ サージカル オペレーションズ, イン | しまい込めるナイフブレードを持つ手術器具 |
KR20190095506A (ko) * | 2011-11-15 | 2019-08-14 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
US10610223B2 (en) | 2011-11-15 | 2020-04-07 | Intuitive Surgical Operations, Inc. | Surgical instrument with stowing knife blade |
KR102111471B1 (ko) | 2011-11-15 | 2020-05-19 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
JP2017205562A (ja) * | 2011-11-15 | 2017-11-24 | インテュイティブ サージカル オペレーションズ, イン | しまい込めるナイフブレードを持つ手術器具 |
KR102153406B1 (ko) | 2011-11-15 | 2020-09-08 | 인튜어티브 서지컬 오퍼레이션즈 인코포레이티드 | 스토잉하는 나이프 블레이드를 가진 수술 기구 |
JP2015532150A (ja) * | 2012-10-15 | 2015-11-09 | エシコン・エンド−サージェリィ・インコーポレイテッドEthicon Endo−Surgery,Inc. | 外科用切断器具 |
US10918387B2 (en) | 2012-12-31 | 2021-02-16 | Intuitive Surgical Operations, Inc. | Surgical staple cartridge with enhanced knife clearance |
US10194908B2 (en) | 2012-12-31 | 2019-02-05 | Intuitive Surgical Operations, Inc. | Surgical staple cartridge with enhanced knife clearance |
JP2018515222A (ja) * | 2015-05-08 | 2018-06-14 | ジャスト ライト サージカル,リミティド ライアビリティ カンパニー | 手術用ステープラ |
Also Published As
Publication number | Publication date |
---|---|
AU2011200484B2 (en) | 2011-11-17 |
EP1464287B1 (en) | 2009-12-30 |
ATE453365T1 (de) | 2010-01-15 |
DE602004024843D1 (de) | 2010-02-11 |
MXPA04003214A (es) | 2004-11-29 |
AU2011200484A1 (en) | 2011-02-24 |
EP1464287A2 (en) | 2004-10-06 |
US20040199181A1 (en) | 2004-10-07 |
JP4672276B2 (ja) | 2011-04-20 |
EP1464287A3 (en) | 2004-12-01 |
AU2004201380A1 (en) | 2004-10-21 |
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