JP2005103301A - 単一内腔アクセス吻合術用のファスナーアプライヤー - Google Patents
単一内腔アクセス吻合術用のファスナーアプライヤー Download PDFInfo
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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
- A61B17/11—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
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0408—Rivets
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
-
- 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
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
Abstract
【解決手段】 吻合すなわち通常は異なる2つの脈管または内腔間の通路の外科的な形成は、中空のリベット形状の取付け具を形成するために別のアンビルを必要としないリング装置を利用するアプライヤーによって容易になる。更に、リング装置を成形ポリマー材料または打抜きされたシート金属から円筒状に形成し、組織壁を並置する形状のヒンジリングを形成する基端側アーム及び先端側アームによって基端側リングと先端側リングを連結する。中心リングすなわち中心部分を取付け部位に配置する。アプライヤーを作動させてリングを相対的に移動させる。ラッチ機構で、リングを作動状態に固定する。
【選択図】 図4
Description
本願は、言及することを以ってその内容の全てを本明細書の一部とする以下に示す4件の係属中の自己の出願に関連する。
(1)ドン・タナカ(Don Tanaka)、マーク・オルティス(Mark Ortiz)、及びダレル・パウエル(Darrel Powell)による米国特許出願第10/674,371号、名称「吻合用ワイヤリング装置(Anastomosis Wire Ring Device)」
(2)ジーン・ボープレ(Jean Beaupre)による米国特許出願第10/675,091号、名称「アンフォールディング吻合用リング装置(Unfolding Anastomosis Ring Device)」
(3)マーク・オルティス(Mark Ortiz)による米国特許出願第10/675,705号、名称「内腔間吻合のための単一内腔配置用リング(Single Lumen Access Deployable Ring for Intralumenal Anastomosis)」
(4)マーク・オルティス(Mark Ortiz)、ロバート・マッケンナ(Robert McKenna)、ビル・クレイマー(Bill Kraimer)、マイク・ストークス(Mike Stokes)、及びフォスター・シュトゥーレン(Foster Stulen)による米国特許出願第10/675,497号、名称「単一内腔吻合用ファスナーアプライヤー(Single Lumen Anastomosis Applier for Fastener)」
(1)前記実施部分が内視鏡外科手術に用いることができる寸法を有することを特徴とする請求項1に記載のアプライヤー。
(2)吻合リング装置用のアプライヤーであって、前記吻合リング装置が、複数の基端側アームによって基端側リングに長手方向に連結されると共に複数の先端側アームによって先端側リングに長手方向に連結された中心円形部分を含み、前記各リングが前記中心円形部分に向かって圧迫されることで前記複数のアームが拡張し、前記アプライヤーが更に、前記基端側リング、前記中心円形部分、及び前記先端側リングからなる群から選択される1つの内部に係合して長手方向に移動させる第1の部材と、前記群の別の1つの内部に係合して、前記複数のアームの少なくとも1つを機械的に作動させる第2の部材とを含むことを特徴とするアプライヤー。
(3)前記リング装置の前記中心円形部分が中心リングであり、前記第2の部材が前記中心リングに係合していることを特徴とする実施態様(2)に記載のアプライヤー。
(4)前記第2の部材が更に、前記中心リングを長手方向に移動できるように機能的に構成されていることを特徴とする実施態様(3)に記載のアプライヤー。
(5)前記第1の部材及び前記第2の部材が、前記吻合装置の作動した状態に応答する解放可能な係合機構を含むことを特徴とする実施態様(3)に記載のアプライヤー。
(7)更に、前記吻合装置を先端側に受容できるように機能的に構成され、内視鏡と共に使用できる寸法を有する、前記第1の部材及び前記第2の部材を支持するカニューレを含むことを特徴とする実施態様(6)に記載のアプライヤー。
(8)吻合リング装置用のアプライヤーであって、前記吻合リング装置が、複数の基端側アームによって基端側リングに長手方向に連結されると共に複数の先端側アームによって先端側リングに長手方向に連結された中心リングを含み、前記各リングが前記中心リングに向かって圧迫されることで前記複数のアームが拡張し、前記アプライヤーが、作動していない前記吻合リング装置を吻合外科部位に挿入する手段と、前記基端側リング及び前記先端側リングを内側に圧迫して前記複数の基端側アーム及び前記複数の先端側アームを作動させるための手段とを含むことを特徴とするアプライヤー。
(9)更に、前記基端側リング及び前記先端側リングからなる群の1つを前記中心リングに対して圧迫して、前記1つのリングの互いに離間した複数のアームを作動させるための手段を含むことを特徴とする実施態様(8)に記載のアプライヤー。
(10)更に、前記複数の基端側アーム及び前記複数の先端側アームを個別に作動させるためのハンドル手段を含むことを特徴とする実施態様(8)に記載のアプライヤー。
12 実施部分
14、16 組織壁
18 導入先端部
20 開口
22 吻合部位
24 作動部分
30 リング装置
32 基端側リング
34 中心リング
36 先端側リング
38 基端側アーム
40 先端側アーム
42、44 ヒンジ接合部
46、48 内側アームセグメント
50、52 外側アームセグメント
54 ハンドル
58 中心リングスライド制御部
60 先端側リングスライド制御部
62 中心リング作動部材
64 先端側リング作動部材
66、68 プロング
70 キャッチ
72 解放ランプ
74 固定フック
Claims (10)
- 吻合リング装置用のアプライヤーであって、
前記吻合リングが、基端側ヒンジアーム及び先端側ヒンジアームによってそれぞれ接続された基端側リング、中心リング、及び先端側リングを備え、作動していない時には円筒状の形状、作動した時にはリベット形状を有し、
前記アプライヤーが、
細長い実施部分と、
前記実施部分に連結されたハンドルと、
前記吻合装置の前記リングの選択した1つのリングの内部に係合した作動部材と、
前記吻合装置の前記リングの選択した第2のリングの内部に係合した拘束部材と、
前記作動部材、従ってその作動部材に係合したリングを前記拘束部材に向かって移動させ、従って前記選択した第2のリングによって前記リング装置の互いに離間した前記ヒンジアームが作動するように機能的に構成された前記ハンドルに結合された制御部とを含むことを特徴とするアプライヤー。 - 前記作動部材が前記先端側リングに係合していることを特徴とする請求項1記載のアプライヤー。
- 前記拘束部材が前記基端側リングの内部に係合していることを特徴とする請求項2記載のアプライヤー。
- 前記ハンドルに結合された第2の制御部を更に含み、前記第2の制御部が、前記拘束部材を前記作動部材に向かって先端側に移動させることができ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3記載のアプライヤー。
- 前記拘束部材が前記中心リングに係合し、前記アプライヤーが更に、前記基端側リングに係合した第2の作動部材と、前記基端側リングを前記中心リングに向かって先端側に移動させることができるように機能的に構成された前記ハンドルに結合された第2の制御部とを含むことを特徴する請求項3記載のアプライヤー。
- 前記作動部材が前記中心リングに係合していることを特徴とする請求項1記載のアプライヤー。
- 前記実施部分が更に、前記ハンドルに連結されたシャフトを含み、前記シャフトの先端側が前記リング装置の前記基端側リングに接触しており、前記アプライヤーが更に、前記リング装置の前記先端側リングの内部に係合した第2の作動部材を含むことを特徴とする請求項6記載のアプライヤー。
- 前記作動部材の先端側がキャッチで終わっていることを特徴とする請求項1記載のアプライヤー。
- 前記作動部材が、前記リング装置の前記選択されたリングから外れるように前記リング装置の作動した状態に応答する解放面を有することを特徴とする請求項8記載のアプライヤー。
- 更に、前記実施部分に連結された先端部照明装置を含むことを特徴とする請求項9記載のアプライヤー。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/675,077 US7452363B2 (en) | 2003-09-30 | 2003-09-30 | Applier for fastener for single lumen access anastomosis |
Publications (2)
Publication Number | Publication Date |
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JP2005103301A true JP2005103301A (ja) | 2005-04-21 |
JP4658556B2 JP4658556B2 (ja) | 2011-03-23 |
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Application Number | Title | Priority Date | Filing Date |
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JP2004288241A Expired - Fee Related JP4658556B2 (ja) | 2003-09-30 | 2004-09-30 | 単一内腔アクセス吻合術用のファスナーアプライヤー |
Country Status (11)
Country | Link |
---|---|
US (1) | US7452363B2 (ja) |
EP (1) | EP1520530B1 (ja) |
JP (1) | JP4658556B2 (ja) |
CN (1) | CN1640367A (ja) |
AT (1) | ATE448736T1 (ja) |
AU (2) | AU2004216629A1 (ja) |
BR (1) | BRPI0404238B1 (ja) |
CA (1) | CA2483719C (ja) |
DE (1) | DE602004024162D1 (ja) |
ES (1) | ES2334131T3 (ja) |
MX (1) | MXPA04009610A (ja) |
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CA2483719A1 (en) | 2005-03-30 |
ES2334131T3 (es) | 2010-03-05 |
JP4658556B2 (ja) | 2011-03-23 |
CA2483719C (en) | 2012-05-15 |
DE602004024162D1 (de) | 2009-12-31 |
AU2011202355A1 (en) | 2011-06-09 |
MXPA04009610A (es) | 2005-07-12 |
EP1520530A1 (en) | 2005-04-06 |
ATE448736T1 (de) | 2009-12-15 |
AU2011202355B2 (en) | 2012-04-26 |
BRPI0404238B1 (pt) | 2014-02-25 |
AU2004216629A1 (en) | 2005-04-14 |
CN1640367A (zh) | 2005-07-20 |
US20050070926A1 (en) | 2005-03-31 |
US7452363B2 (en) | 2008-11-18 |
BRPI0404238A (pt) | 2005-05-24 |
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LAPS | Cancellation because of no payment of annual fees |