JP2005523105A - マイクロ電気機械的システム(mems)を含む外科用器具 - Google Patents
マイクロ電気機械的システム(mems)を含む外科用器具 Download PDFInfo
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Abstract
Description
本出願は、米国仮出願第60/375,495号および米国仮出願第60/375,496号(両者とも2002年4月25日に出願された)への利益および優先権を請求しており、それらの全体の開示は本明細書に参考として援用されている。
1.技術分野
本開示は、外科用器具、そしてより詳細には、機械的、電気機械的およびエネルギーベースの、外科用器具ならびにシステムに関する。
開放かつ最小侵襲的な手術で用いられる外科用器具は、手術を行うために重要な状態および/またはパラメーターならびに因子を感知および/または制御するそれらの能力は制限されている。例えば、従来の外科用器具は、外科用器具の端部エフェクターの組織接触表面間に位置決めされた組織の量を測定可能に検出することはできない。
本発明は外科用器具に関し、これは、組織に係合するような形状でありかつ適合された端部エフェクター;および状態を感知すること、パラメーターを測定すること、および上記端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのための、上記外科用器具に作動可能に連結される、少なくとも1つのマイクロ電気機械的システム(MEMS)を備える。この少なくとも1つのMEMSデバイスは、上記端部エフェクターに作動可能に連結される。この少なくとも1つのMEMSデバイスは、関連する状態および/またはパラメーターを感知すること、測定すること、および制御することの少なくとも1つのための、圧力センサー、ひずみセンサー、変位センサー、光学センサー、バイオセンサー、温度センサー、トルクセンサー、加速度計、フローセンサー、電気センサーおよび磁気センサーの少なくとも1つである。
本明細書に開示される外科用器具およびシステムの好ましい実施形態は、描写された図面を参照して詳細にここに説明され、ここで、同様の参照番号は、類似または同一のエレメントを識別する。本明細書で用いられるとき、および従来のように、用語「遠位」は、ユーザーから遠い部分をいい、その一方、用語「近位」は、ユーザーにより近い部分をいう。
Claims (69)
- 外科用器具であって:
組織に係合するような形状でありかつ適合された端部エフェクター;および
状態を感知すること、パラメーターを測定すること、および該端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのための、該外科用器具に作動可能に連結された、少なくとも1つのマイクロ電気機械的システム(MEMS)デバイス、
を備える、外科用器具。 - 前記少なくとも1つのMEMSデバイスが、前記端部エフェクターに作動可能に連結された、請求項1に記載の外科用器具。
- 前記少なくとも1つのMEMSデバイスが、関連する状態および/またはパラメーターを感知すること、測定すること、および制御することの少なくとも1つのための、圧力センサー、ひずみセンサー、変位センサー、光学センサー、バイオセンサー、温度センサー、トルクセンサー、加速度計、フローセンサー、電気センサーおよび磁気センサーからなる群から選択される、請求項2に記載の外科用器具。
- 前記外科用器具が、外科用ステープラーであり、そして前記端部エフェクターが:
ステープルカートリッジアセンブリ;および
該ステープルカートリッジと作動可能に関連するアンビル
を備え、該ステープルカートリッジおよびアンビルは、互いに移動可能に連結されて、一方を他方に対して並置する、
請求項3に記載の外科用器具。 - 前記ステープルカートリッジおよびアンビルの各々が、組織接触表面を規定し、そして前記少なくとも1つのMEMSデバイスが、該ステープルカートリッジの組織接触表面および該アンビルの組織接触表面の少なくとも1つに作動可能に連結された、請求項4に記載の外科用器具。
- 前記外科用器具に連結される複数のMEMSデバイスが存在し、該MEMSデバイスが、前記ステープルカートリッジアセンブリの組織接触表面と前記アンビルの組織接触表面との間の距離を測定するような形状でありかつ適合されている、請求項5に記載の外科用器具。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織に付与される圧力の量を測定するような形状でありかつ適合されている、請求項6に記載の外科用器具。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織の厚さを測定するような形状でありかつ適合されている、請求項4に記載の外科用器具。
- 前記端部エフェクターが、吻合を実施するような形状でありかつ適合されている、請求項4に記載の外科用器具。
- 前記外科用器具が、内視鏡による胃腸管吻合を実施するような形状でありかつ適合されている直線状のステープラーである、請求項9に記載の外科用器具。
- 前記外科用器具が、端と端とを接した吻合を実施するように適合されている環状ステープラーである、請求項9に記載の外科用器具。
- 前記端部エフェクターが、細長いシャフトの遠位端に旋回可能に連結された一対のジョー部材を含むジョー機構である、請求項3に記載の外科用器具。
- 少なくとも1つのMEMSデバイスが、前記一対のジョー部材の少なくとも1つの上に提供される、請求項12に記載の外科用器具。
- MEMSデバイスが、前記一対のジョー部材の各々の近位端、遠位端およびその長さに沿ってのうちの少なくとも1つに提供される、請求項13に記載の外科用器具。
- 前記ジョー機構が、電気外科機能を実施する形状でありかつ適合されている、請求項14に記載の外科用器具。
- 前記ジョー機構が、標的外科部位に電気外科用エネルギーを送達するよう形状でありかつ適合されている、請求項15に記載の外科用器具。
- 前記外科用器具が、ロボットシステムに作動可能に連結可能であり、前記端部エフェクターが該ロボットシステムによって遠隔から作動される形状でありかつ適合されている、請求項3に記載の外科用器具。
- 近位端および遠位端を有する装填ユニットが含められ、該近位端が、前記外科用器具に選択的に除去可能に連結され、前記端部エフェクターが該装填ユニットに作動可能に連結されかつその一部であり、そして該装填ユニットが前記少なくとも1つのMEMSデバイスを含む、請求項1に記載の外科用器具。
- 前記端部エフェクターが、外科用ステープラーであり、該外科用ステープラーは、
ステープルカートリッジアセンブリ;および
該ステープルカートリッジアセンブリに作動可能に関連するアンビル
を含み、
該ステープルカートリッジアセンブリおよび該アンビルは、互いに対して移動可能でかつ並置可能である、
請求項18に記載の外科用器具。 - 前記ステープルカートリッジアセンブリおよびアンビルの各々が、組織接触表面を規定し、そして前記少なくとも1つのMEMSデバイスが、該ステープルカートリッジの組織接触表面および該アンビルの組織接触表面の少なくとも1つに作動可能に連結された、請求項19に記載の外科用器具。
- 前記MEMSデバイスが、前記ステープルカートリッジアセンブリの組織接触表面と前記アンビルの組織接触表面との間の距離を測定するような形状でありかつ適合されている、請求項20に記載の外科用器具。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織に付与される圧力の量および該組織の厚さのうちの少なくとも1つを測定するような形状でありかつ適合されている、請求項20に記載の外科用器具。
- 前記装填ユニットが、遠位端を有する細長いシャフトを有し、前記端部エフェクターが、細長いシャフトの遠位端に作動可能に連結され、そして前記ステープルカートリッジおよびアンビルが、該細長いシャフトに対して横方向に配向されている、請求項18に記載の外科用器具。
- 前記端部エフェクターが、吻合を実施するような形状でありかつ適合されている、請求項18に記載の外科用器具。
- 前記端部エフェクターが、前記細長いシャフトの遠位端に旋回可能に連結された一対のジョー部材を含むジョー機構である、請求項18に記載の外科用器具。
- 前記少なくとも1つのMEMSデバイスが、前記一対のジョー部材の少なくとも1つの上に提供される、請求項25に記載の外科用器具。
- MEMSデバイスが、前記一対のジョー部材の各々の近位端、遠位端およびその長さに沿ってのうちの少なくとも1つに提供される、請求項28に記載の外科用器具。
- 前記ジョー機構が、電気外科機能を実施する形状でありかつ適合されている、請求項27に記載の外科用器具。
- 前記ジョー機構が、標的外科部位に電気外科用エネルギーを送達するよう形状でありかつ適合されている、請求項28に記載の外科用器具。
- 前記複数のMEMSの各々が、ハウジングから伸びる配線ワイヤを経由してコントロールボックスに電気的に連結された、請求項3に記載の外科用器具。
- 少なくとも1つのワイヤ配線を経由して前記複数のMEMSデバイスの各々に電気的に連結されるコントロールボックスをさらに備える、請求項3に記載の外科用器具。
- 外科的仕事を実施するためのロボットシステムであって:
フレーム;
該フレームに連結されかつ該フレームに対して移動可能な、ロボットアーム;
該ロボットアームの作動および移動を制御するための、該ロボットアームと作動可能に関連する作動アセンブリ;
該ロボットアームに作動可能に連結された細長いシャフト、および該細長いシャフトの遠位端に作動可能に連結されかつ組織に係合する形状である端部エフェクターを含む、装填ユニット;ならびに
状態を感知すること、パラメーターを測定すること、および該端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのための、該装填ユニットに作動可能に連結された少なくとも1つのマイクロ電気機械的システム(MEMS)デバイス、を備える、システム。 - 前記少なくとも1つのMEMSデバイスが、関連する状態および/またはパラメーターを感知すること、測定すること、および制御することの少なくとも1つのための、圧力センサー、ひずみセンサー、変位センサー、光学センサー、バイオセンサー、温度センサー、トルクセンサー、加速度計、フローセンサー、電気センサーおよび磁気センサーからなる群から選択される、請求項32に記載のロボットシステム。
- 前記端部エフェクターが、前記細長いシャフトの遠位端に移動可能に連結された一対のジョー部材を含む、請求項32に記載のロボットシステム。
- 複数のMEMSデバイスが、前記一対のジョー部材の各々の上に提供される、請求項34に記載のロボットシステム。
- 複数のMEMSデバイスが、前記一対のジョー部材の各々の近位端、遠位端およびその長さに沿っての少なくとも1つに提供される、請求項34に記載のロボットシステム。
- DLUが、バイヨネットタイプ連結を経由して前記ロボットアームに連結された、請求項32に記載のロボットシステム。
- 前記端部エフェクターが、電気外科機能を実施する形状でありかつ適合されている、請求項32に記載のロボットシステム。
- 前記端部エフェクターが、標的外科部位に電気外科用エネルギーを送達するよう形状でありかつ適合されている、請求項32に記載のロボットシステム。
- 前記作動アセンブリから伝達された電気信号を受けるため、および前記装填ユニットの作動および移動を制御するための、プロセッサーおよびレシーバーを含むコントローラーをさらに備える、請求項32に記載のシステム。
- 前記端部エフェクターが、ファスナーアプライヤー、外科用ステープラー、脈管クリップアプライヤーおよび脈管縫合アセンブリからなる群から選択される、請求項32に記載のロボットシステム。
- 前記端部エフェクターが、ステープルカートリッジアセンブリ、および該ステープルカートリッジアセンブリと作動可能に関連しかつ該ステープルカートリッジアセンブリに対して並置されるアンビルを含む、ステープラーであり、少なくとも1つのMEMSデバイスが、該ステープルカートリッジアセンブリおよび該アンビルの各々に作動可能に連結されている、請求項32に記載のロボットシステム。
- 前記ステープルカートリッジアセンブリが組織接触表面を規定し、そしてここで少なくとも1つのMEMSデバイスが、該ステープルカートリッジアセンブリの組織接触表面に作動可能に連結された、請求項42に記載のロボットシステム。
- 前記アンビルが組織接触表面を規定し、そしてここで少なくとも1つのMEMSデバイスが、前記ステープルカートリッジの組織接触表面に作動可能に連結される、請求項43に記載のロボットシステム。
- 前記MEMSデバイスが、前記ステープルカートリッジアセンブリの組織接触表面と前記アンビルの組織接触表面との間の距離を測定するような形状でありかつ適合されている、請求項44に記載の外科用器具。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織に付与される圧力の量を測定するような形状でありかつ適合されている、請求項44に記載の外科用器具。
- 前記ステープルカートリッジアセンブリおよび前記アンビルが、前記細長いシャフトに対して横方向に配向されている、請求項44に記載のロボットシステム。
- 前記ステープルカートリッジアセンブリおよび前記アンビルが、前記細長いシャフトの遠位端に旋回可能に連結された、請求項44に記載のロボットシステム。
- 前記端部エフェクターが脈管クリップアプライヤーであり、該脈管クリップアプライヤーが:
遠位端および近位端を有する本体部分であり、ここで、該近位端が、前記ロボットアームに作動可能に連結された、本体部分;および
該本体部分の遠位端に作動可能に連結されるジョーアセンブリ
を備え、
ここで、該ジョーアセンブリが、第1および第2のジョー部分を含む、請求項32に記載のロボットシステム。 - 前記第1および第2のジョー部分が、それらに連結された少なくとも1つのMEMSデバイスを含む、請求項49に記載のロボットシステム。
- 前記端部エフェクターが脈管縫合アセンブリであり、該脈管縫合アセンブリが:
遠位端および近位端を有する細長い本体であって、ここで該近位端が前記ロボットアームに作動可能に連結された、本体;および
該細長い本体の部分の遠位端に旋回可能に取り付けられた一対のニードル受容ジョーであって、該一対のニードル受容ジョーは、外科用ニードル、および関連する長さの縫合材料をそれらの間に通す形状でありかつ適合される、受容ジョー
を供える、請求項32に記載のロボットシステム。 - 前記一対のニードル受容ジョーの各々に作動可能に連結された少なくとも1つのMEMSコンポーネントをさらに含む、請求項51に記載のロボットシステム。
- 近位端および遠位端を有する細長い管状シャフト;
該管状シャフトの遠位端に作動可能に連結される端部エフェクター;
該管状シャフトの近位端を外科用器具に連結するコネクター;ならびに
状態を感知すること、パラメーターを測定すること、および該端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのための、該装填ユニットに作動可能に連結された、少なくとも1つのマイクロ電気機械的システム(MEMS)デバイス、
を備える、外科用器具との使用のための装填ユニット。 - 前記少なくとも1つのMEMSデバイスが、前記端部エフェクターに作動可能に連結された、請求項53に記載の装填ユニット。
- 前記少なくとも1つのMEMSデバイスが、関連する状態および/またはパラメーターを感知すること、測定すること、および制御することの少なくとも1つのための、圧力センサー、ひずみセンサー、変位センサー、光学センサー、バイオセンサー、温度センサー、トルクセンサー、加速度計、フローセンサー、電気センサーおよび磁気センサーからなる群から選択される、請求項54に記載の装填ユニット。
- 前記外科用器具が、外科用ステープラーであり、そして前記端部エフェクターが:
ステープルカートリッジアセンブリ;および
該ステープルカートリッジと作動可能に関連するアンビル
を備え、該ステープルカートリッジおよび該アンビルは、互いに移動可能に連結され、一方を他方に対して並置する、請求項55に記載の装填ユニット。 - 前記ステープルカートリッジおよび該アンビルの各々が、組織接触表面を規定し、そして前記少なくとも1つのMEMSデバイスが、該ステープルカートリッジの組織接触表面および該アンビルの組織接触表面の少なくとも1つに作動可能に連結された、請求項54に記載の装填ユニット。
- 前記外科用器具に連結された複数のMEMSデバイスが存在し、該MEMSデバイスは、前記ステープルカートリッジアセンブリの組織接触表面と前記アンビルの組織接触表面との間の距離を測定するような形状でありかつ適合されている、請求項57に記載の装填ユニット。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織に付与される圧力の量を測定するような形状でありかつ適合されている、請求項58に記載の装填ユニット。
- 前記MEMSデバイスが、前記ステープルカートリッジの組織接触表面と前記アンビルの組織接触表面との間にクランプされた組織の厚さを測定するような形状でありかつ適合されている、請求項57に記載の装填ユニット。
- 前記端部エフェクターが、吻合を実施するような形状でありかつ適合されている、請求項56に記載の装填ユニット。
- 前記外科用器具が、内視鏡による胃腸管吻合を実施するような形状でありかつ適合されている、直線状のステープラーである、請求項61に記載の装填ユニット。
- 前記外科用器具が、端と端とを接した吻合を実施するように適合されている環状ステープラーである、請求項62に記載の装填ユニット。
- 前記端部エフェクターが、細長いシャフトの遠位端に旋回可能に連結された一対のジョー部材を含むジョー機構である、請求項55に記載の装填ユニット。
- 少なくとも1つのMEMSデバイスが、前記一対のジョー部材の少なくとも1つの上に提供される、請求項64に記載の装填ユニット。
- MEMSデバイスが、前記一対のジョー部材の各々の近位端、遠位端およびその長さに沿っての少なくとも1つに提供される、請求項75に記載の装填ユニット。
- 前記少なくとも1つのMEMSデバイスが、温度感知MEMSデバイスである、請求項53に記載の装填ユニット。
- 前記温度感知MEMSデバイスが、熱伝導性チップまたは熱伝導性エレメント上に配置されかつ/またはその中に被包され、ここで、該熱伝導性チップが特定用途のための形状記憶合金から作製された半剛直性ワイヤであり、ここで、該伝導性チップが、前記装填ユニットに隣接する組織の温度をモニターするために、該装填ユニットから外にかつ該装填ユニットに隣接する組織中に伸長可能である、請求項67に記載の装填ユニット。
- 装填ユニットとの使用のための外科用器具であって、該装填ユニットは、該外科用器具に作動可能に接続可能であり、該装填ユニットは、外科用機能を実施するための一対の並置可能なジョーをもつ端部エフェクターを有し、該端部エフェクターは、状態を感知すること、パラメーターを測定すること、および該端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのために端部エフェクターに作動可能に連結された、少なくとも1つのマイクロ電気機械的システム(MEMS)デバイスを有し、該外科用器具は、
ハウジング;
該ハウジングから伸び、そして上記タイプの装填ユニットに作動可能に連結可能な遠位端を有する、細長いシャフト;
該一対のジョーに隣接するための隣接機構;
該ジョーが該外科用機能を実施するよう起動するための作動機構;および
状態を感知すること、パラメーターを測定すること、および該端部エフェクターに隣接する状態および/またはパラメーターを制御することの少なくとも1つのため、かつ該端部エフェクターの少なくとも1つのMEMSとの協働作動のために、該外科用器具に作動可能に連結された、少なくとも1つのマイクロ電気機械的システム(MEMS)、
を備える、外科用器具。
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EP1496805A2 (en) | 2005-01-19 |
US20160030042A1 (en) | 2016-02-04 |
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US20120016362A1 (en) | 2012-01-19 |
US9295468B2 (en) | 2016-03-29 |
WO2003090630A3 (en) | 2004-04-08 |
US9962159B2 (en) | 2018-05-08 |
US20140336641A1 (en) | 2014-11-13 |
AU2009200903B2 (en) | 2011-04-07 |
US9561031B2 (en) | 2017-02-07 |
US20160256164A1 (en) | 2016-09-08 |
CA2483094A1 (en) | 2003-11-06 |
ES2377483T3 (es) | 2012-03-28 |
US10575849B2 (en) | 2020-03-03 |
AU2009200903A1 (en) | 2009-03-26 |
AU2011201490B2 (en) | 2012-04-05 |
US8808311B2 (en) | 2014-08-19 |
AU2011201490A1 (en) | 2011-04-28 |
AU2003245246B2 (en) | 2009-01-08 |
JP4431404B2 (ja) | 2010-03-17 |
CA2483094C (en) | 2011-03-15 |
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