JP2005028148A - 横方向に移動する関節動作制御部を備えた外科器具 - Google Patents
横方向に移動する関節動作制御部を備えた外科器具 Download PDFInfo
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- 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
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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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
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2943—Toothed members, e.g. rack and pinion
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- A—HUMAN NECESSITIES
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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Abstract
【解決手段】内視鏡と共に使用するのに適した関節動作外科器具であって、関節動作の方向や程度について関節動作制御部による視覚的な表示や触覚を感覚的に医師に提供する横方向関節動作制御部がハンドル部分に設けられている。横方向制御操作部の横方向の移動が、長手方向の移動または回動動作に変換され、シャフトを介して関節動作機構に伝達される。回動により関節動作機構を作動させるための横方向の関節動作制御部の一形態は、エンドエフェクタに力が加わって選択した関節動作の角度が変わるのを防止する関節動作逆作動防止装置を備えている。
【選択図】図2
Description
本願は、それぞれ言及することを以って本明細書の一部とする4つの同時係属中の自己の同時出願に関連する。これらの同時出願の名称は次の通りである。
(1)ケネス・エス・ウェールズ(Kenneth S. Wales)、ダグラス・ビー・ホフマン(Douglas B. Hoffman)、フレデリック・イー・シェルトン4世(Frederick E.Shelton IV)、及びジェフ・スウェイズ(Jeff Swayze)による、「長軸に対して回動させる関節動作機構を備えた外科器具(SURGICAL INSTRUMENT INCORPORATING AN ARTICULATION MECHANISM HAVING ROTATION ABOUT THE LONGITUDINAL AXIS)」。
(2)ダグラス・ビー・ホフマン(Douglas B. Hoffman)による、「発射バーの通路を確保する関節動作接続部を備えた外科用ステープラ(SURGICAL STAPLING INSTRUMENT INCORPORATING AN ARTICULATION JOINT FOR A FIRING BAR TRACK)」。
(3)ケネス・エス・ウェールズ(Kenneth S. Wales)及びジョセフ・チャールズ・フエイル(Joseph Charles Hueil)による、「発射バーを支持するための関節動作接続部支持プレートを備えた外科用ステープラ(SURGICAL STAPLING INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FOR SUPPORTING A FIRING BAR)」。
(4)フレデリック・イー・シェルトン4世(Frederick E.Shelton IV)、マイク・セッツァー(Mike Setser)、及びブルース・ウエイスンバーグ(Bruce Weisenburgh)による、「関節動作接続部の高い可撓性を得るためにテーパ状発射バーを備えた外科用ステープラ(SURGICAL STAPLING INSTRUMENT INCORPORATING A TAPERED FIRING BAR FOR INCREASED FLEXIBILITY AROUND THE ARTICULATION JOINT)」。
図3−図5を参照すると、複数の機能を果たすべくEビーム発射バー14を採用したエンドエフェクタ12が示されている。図3では、発射バー14が基端側に配置されているため、未使用のステープルカートリッジ37を細長い溝形部材16内に装着することができる。詳細には、発射バー14の上部ピン38が、アンビルポケット40として示されている凹部内に受容されているため、アンビル18を繰り返し開閉することができる。図4に示されているようにエンドエフェクタが閉じた状態では、上部ピン38が長手方向のアンビルスロット42内に進入して、発射バー14がアンビル18に係合して前進することができる。発射バー14が溝形部材のスロット45内に延在することにより、最も下のピンすなわち発射バーキャップ44が細長い溝形部材16の下面に係合する。中間ピン46が、発射バーキャップ44と協働して細長い溝形部材16の上面にスライド可能に係合する。従って、発射バー14が発射中のエンドエフェクタ12の間隔を確実に維持し、クランプされた組織の量が過少な場合に起こる締め付けや、クランプされた組織の量が過剰な場合に起こるステープル留め不良が防止される。
図6‐図7を参照すると、ガラス充填ポリカーボネートなどのポリマー材料から成形された第1のベース部分50及び第2のベース部分52から構成されるハンドル部分20が示されている。第1のベース部分50は、複数の円筒状のピン54を備えている。第2のベース部分52は、それぞれが六角形の開口58を備えた複数の延出部材56を含む。円筒状のピン54は、六角形の開口58内に受容されて摩擦により保持され、これにより、第1のベース部分50と第2のベース部分52の組立てが維持される。
図6‐図9を参照すると、ハンドル部分20に、実施部分22を外科器具10の長軸を中心に回動させ、その長軸に対して所定の角度にエンドエフェクタ12を関節動作させる関節動作制御部13が組み込まれている。中空の関節動作駆動チューブ200が、閉止スリーブ32内に同軸的に配置され、関節動作レバー202に機能的に接続されているため、関節動作レバー202の回動により、チューブ200が長軸を中心に回動し、これにより閉止リング250及びエンドエフェクタ12が直角に回動すなわち関節動作する。この閉止リング250の関節動作は、医師が観察しながら操作する作動レバー202の回動の角度及び向きに一致する。例示されている形態では、この関係は1:1であり、作動レバー202の回動の角度が、シャフト23の長軸からの回動の角度に一致し、これにより医師が感覚的に回動の角度を知ることができる。他の角度の関係も選択できることを理解されたい。
図12を参照すると、外科器具402のための横方向関節動作制御部400が例示されている。横方向関節動作制御部400は、関節動作制御ロッド406の長手方向の移動により回動する関節動作機構404を備えている。エンドエフェクタ408が、上記した要領と同様にピボット412によってシャフト組立体410に接続されている。ただし、この接続には、歯車及び回動関節動作駆動チューブが用いられていない。唯一のピボット412が示されているが、この第1のピボット412の軸に沿ってもう1つのピボットが形成されており、これによりエンドエフェクタ408の他の側面がシャフト組立体410に接続されていることを理解されたい。関節動作開口414が、シャフト組立体410の先端部418及びエンドエフェクタ408の基端部420の両方の端部から離間するように延出したピボット412によって形成されている。関節動作開口414の大きさは、所望の最大許容関節動作が可能となるように回動軸の側面の周りに半径方向に画定されている。
図13−図16を参照すると、図11に示されたものと同様に感覚的な制御構造を医師に提供する関節動作外科器具502に用いられる横方向関節動作制御部500が示されている。具体的には、横方向関節動作制御部500が、横方向の移動を回動動作に変換する。この回動動作は、関節動作駆動チューブ504によって関節動作機構(図13−図16には不図示)に伝達される。関節動作駆動チューブ504の上面の長手方向に整合した溝512に噛合するように、歯が下側に延出したラック506が、横方向制御アクチューター510の下側508に取り付けられている。
(1)前記関節動作制御部が更に、前記関節動作機構の回動軸からずれた取付け部で前記エンドエフェクタに接続された長手方向の制御ロッドを含み、前記運動変換機構が、前記横方向の運動を長手方向の運動に変換するように機能的に構成されていることを特徴とする請求項1に記載の外科器具。
(2)前記運動変換機構が、前記横方向の運動を前記長手方向の運動に変換するための歯車手段を含むことを特徴とする実施態様(1)に記載の外科器具。
(3)前記運動変換機構が、前記関節動作制御部に接続された横方向のラックと、前記関節動作制御部の前記ラックに噛合した歯車と、前記長手方向の制御ロッドに接続され、前記歯車に噛合した長手方向のラックとを含むことを特徴とする実施態様(1)に記載の外科器具。
(4)前記シャフトが更に、回動動作として前記関節動作を前記関節動作機構に伝達する関節動作駆動チューブを含むことを特徴とする請求項1に記載の外科器具。
(5)前記運動変換機構が、前記横方向の運動を前記回動動作に変換するための歯車を含むことを特徴とする実施態様(4)に記載の外科器具。
(7)前記運動変換機構が更に、前記関節動作制御部を前記横方向のラックに接続する逆作動防止機構を含むことを特徴とする実施態様(6)に記載の外科器具。
(8)前記逆作動防止機構が、窓を備えたフレームと、前記フレームの窓内の所定の位置に横方向に固定され、前記横方向のラックに接続された逆作動防止部材と、前記関節動作制御部に接続され、係合しないで前記逆作動防止部材を横方向に位置合わせするように配置された変形用部材とを含むことを特徴とする実施態様(7)に記載の外科器具。
(9)前記逆作動防止機構が、前記関節動作駆動チューブから前記関節動作機構に運動を伝達するのを防止するための手段を含むことを特徴とする実施態様(7)に記載の外科器具。
(10)前記横方向関節動作制御部が更に、逆作動防止機構を含むことを特徴とする請求項2に記載の外科器具。
11 関節動作機構
12、408 エンドエフェクタ
13 関節動作制御部
14 Eビーム発射バー
16 溝形部材
18 アンビル
20 ハンドル部分
22、270 実施部分
23 シャフト
24 ピストルグリップ
26 閉止トリガ
28 発射トリガ
30 解放ボタン
32 閉止スリーブ
33、250 閉止リング
34、272 フレーム
35 閉止チューブ
36 発射駆動部材
37 ステープルカートリッジ
38 上部ピン
40 アンビルポケット
41 ウェッジスレッド
42 アンビルスロット
43 ステープルドライバ
44 発射バーキャップ
45 スロット
46 中間ピン
47 ステープル
48 切断縁
49 垂直スロット
50 第1のベース部分
52 第2のベース部分
54 円筒状ピン
56 延出部材
58 六角形開口
60 ハウジングキャップ
62 貫通孔
64 ボス
70 外周ノッチ
72 溝形部材固定部材
74 ハンドル部分
76 歯車部分
78 中間部分
86 ヨーク
89 凹部
102、112、124 ばね
104 第1のクランプフック
107 ロックアウトピン
118 上部ラッチアーム
122 凹部
128 係合面
130 前面
136 マルチプライヤ
138 駆動部材
140 金属製駆動ロッド
141 第1のギアラック
142 第2のギアラック
144 第1のノッチ
146 歯
148 第2のノッチ
150 第1のピニオンギア
152 第2のピニオンギア
154 第1のギアラック
200、242、504 関節動作駆動チューブ
202 作動レバー
204 関節動作伝達ハウジング
206 外部タブ
208 関節動作本体
210 円筒状凹部
212 プロング
214 開口
216 環状の歯
220 関節動作ヨーク
224 ボス
226 スロット
227 タブ
240 平歯車関節動作機構
244 歯車部分
246 第1の外周部
248、258 平歯車
252、260 回動点
256 歯車部分
253 ピン
262 逆転歯車
264、266 ピボット孔
268 フレーム開口
274 ブシュ
276 フレーム溝
280 発射コネクタ
288 発射バースロットガイド
290 関節動作フレーム部材
292 溝形部材固定部材
294 取付けカラー
295 下側スロット
296 弾性コネクタ
306 アンビルカムスロット
308 アンビルピボット
310 タブ
312 アンビルタブ
314 閉止面
316 柱状閉止面
400、500 横方向関節動作制御部
402、502 外科器具
404 関節動作機構
406 関節動作制御ロッド
410 シャフト組立体
412 ピボット
414 関節動作開口
424、564 ノブ
426、510 横方向関節動作制御操作部
430 中心部分
432、442、506 ラック
438 細長い歯車
512 溝
516 関節動作逆作動防止装置
518 ラックプレート
520 中心開口
522 X形ロック部材
524、526 変形用ブレード
532、534 駆動ブレード
540 傾斜した歯
542 当接面
548 先端縁
550 右先端側アーム
552 左先端側アーム
558 基端縁
560 右基端側アーム
562 左基端側アーム
566 右端部
568 左端部
Claims (4)
- 外科器具であって、
エンドエフェクタと、
関節動作伝達部材を備えたシャフトと、
前記エンドエフェクタを前記シャフトの先端部に回動可能に接続する、関節動作に応答する関節動作機構と、
前記シャフトの基端部分に接続された関節動作制御部とを含み、
前記関節動作制御部が、
使用者が横方向に配置可能な操作部と、
前記関節制御部からの横方向の運動を関節動作に変換するように機能的に構成された、前記操作部及び前記関節動作機構に接続された運動変換機構とを有することを特徴とする外科器具。 - 外科器具であって、
作動動作、及びシャフトの長軸を中心とした回動動作を個別に伝達するように構成された前記シャフトと、
前記作動動作に応答するエンドエフェクタと、
前記回動動作に応答して前記エンドエフェクタを前記シャフトの長軸から関節動作させる関節動作機構と、
前記作動動作を引き起こすことができるように機能的に構成された前記シャフトに接続されたハンドル部分と、
前記回動動作を引き起こすことができるように機能的に構成された、使用者が横方向に位置合わせ可能な横方向関節動作制御部とを含むことを特徴とする外科器具。 - 外科器具であって、
発射動作、閉止動作、及び関節動作を引き起こすことができるハンドル部分と、
前記発射動作、前記閉止動作、及び前記関節動作を個別に伝達することができる前記ハンドル部分に接続されたシャフトと、
前記シャフトに接続された細長い溝形部材と、
前記細長い溝形部材に回動可能に接続され、前記シャフトからの前記閉止動作に応答するアンビルと、
前記細長い溝形部材と前記アンビルとの間に長手方向に受容された先端側に設けられた切断縁を含む発射装置と、
前記関節動作に応答して前記シャフトから前記細長い溝形部材を回動させる関節動作機構と、
前記回動動作を引き起こすことができるように機能的に構成された、使用者が横方向に位置合わせ可能な横方向関節動作制御部とを含むことを特徴とする外科器具。 - 外科器具であって、
前記外科器具の長軸を画定するシャフトと、
前記長軸に整合した第1の位置から前記長軸と所定の角度を成す第2の位置まで移動可能なエンドエフェクタと、
前記エンドエフェクタに機能的に接続された、回動により前記エンドエフェクタを前記第1の位置から前記第2の位置に移動させることができる回動部材と、
前記回動部材に機能的に接続された、前記長軸に対して横方向に移動可能な横方向制御部材とを含み、
前記横方向制御部材の横方向の移動により、前記エンドエフェクタが前記第1の位置から前記第2の位置に移動することを特徴とする外科器具。
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US10/615,972 US6981628B2 (en) | 2003-07-09 | 2003-07-09 | Surgical instrument with a lateral-moving articulation control |
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JP4667774B2 JP4667774B2 (ja) | 2011-04-13 |
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EP (1) | EP1522263B1 (ja) |
JP (1) | JP4667774B2 (ja) |
CN (1) | CN1596833A (ja) |
AU (2) | AU2004203122A1 (ja) |
BR (1) | BRPI0402681B8 (ja) |
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Cited By (219)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
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Also Published As
Publication number | Publication date |
---|---|
AU2010257302A1 (en) | 2011-01-13 |
CN1596833A (zh) | 2005-03-23 |
EP1522263A1 (en) | 2005-04-13 |
MXPA04006764A (es) | 2005-04-19 |
CA2473482A1 (en) | 2005-01-09 |
AU2010257302B2 (en) | 2012-03-29 |
AU2004203122A1 (en) | 2005-01-27 |
EP1522263B1 (en) | 2017-01-18 |
BRPI0402681B1 (pt) | 2016-10-18 |
CA2473482C (en) | 2012-11-13 |
US6981628B2 (en) | 2006-01-03 |
US20050006430A1 (en) | 2005-01-13 |
JP4667774B2 (ja) | 2011-04-13 |
BRPI0402681B8 (pt) | 2021-06-22 |
BRPI0402681A (pt) | 2005-03-29 |
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