JP2006218296A - ストロークの後退の自動式の端部を伴う多数回ストローク式の機構 - Google Patents
ストロークの後退の自動式の端部を伴う多数回ストローク式の機構 Download PDFInfo
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Abstract
【解決手段】ハンドルは複数の発射ストロークを生じてエンド・エフェクタの発射(すなわちステープルや切断)に必要な力を減少させる。リンク型の伝達により、ハンドルに必要な長手方向の長さを縮小する一方、発射のため直線状にすると剛性で丈夫な構成を達成する。牽引バイアス型の発射機構は、抗後退機構と、そして発射中に閉鎖トリガを解放することを阻止するロックアウト機構と、協働して、上記のような直線状のリンク型のラックの駆動における拘束を回避する。さらに、外部の指示手段が、発射の進行している程度に関して、外科医にフィードバック情報を与えると共に、手動の後退を可能にしている。
【選択図】図1
Description
本特許出願は2003年9月29日に出願されていて、ジェフリー・S.スウェイズ(Jeffrey S. Swayze)、フレデリック・イー・シェルトン四世(Frederick E. Shelton IV)に譲渡されている、「サージカル・ステープリング・インストルメント・インコーポレイティング・ア・ファイアリング・メカニズム・ハビング・ア・リンクド・ラック・トランスミッション(SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING A LINKED RACK TRANSMISSION)」を発明の名称とする、米国特許出願第10/673,930号の一部継続出願であり、この開示は、このように、その全体において、参照により本明細書に組み入れられている。
本発明は一般に組織に対してステープル線を供給すると共にそれらのステープル線の間の組織を切断することのできる外科ステープル器具に関連しており、特に、ステープル器具に関連する改善およびトリガの多数回のストロークによる発射を達成する上記のようなステープル器具における種々の部品を形成するための方法の改善に関連している。
内視鏡手術器具は比較的に小さな切開部分が術後の回復時間および合併症を減少させる傾向があるので、従来の開放性の外科装置よりも好まれる場合が多い。この結果、トロカールのカニューレを通して所望の外科部位における先端側のエンド・エフェクタの正確な配置決めに適している内視鏡外科器具の領域においてかなりの開発が行なわれてきた。これらの先端側のエンド・エフェクタは診断または治療の効果を達成するための多数の方法で組織に対して係合する(例えば、端部切断装置、把持装置、切断装置、ステープラー、クリップ供給装置、アクセス装置、薬物/遺伝子療法用の送達装置、および超音波、RF、レーザー等を用いるエネルギー装置等)。
本発明は、外科医により必要とされる過度の手の力を伴わずに、長いエンド・エフェクタを作動させる多数回発射ストローク式のハンドルを好都合に組み込んでいる外科ステープル用および切断用の器具を提供することにより、従来技術の上記およびその他の欠陥を解消している。この場合に、エンド・エフェクタに発射力を伝える発射部材が、後退を補助するために、基端側にバイアス力が加えられている。さらに、発射ストロークの間の後退を避けるために、発射機構により解除されると、抗後退機構は上記の発射部材を拘束する。本発明の各態様に一貫している抗後退解放機構は、上記の発射部材が後退するように、その抗後退解放機構を無能にすることにより、上記の発射部材の完全な発射距離の移動に応じる。
外科ステープル用および切断用の器具は、従来の連続型か、比較的に短いハンドルに対応して好都合に示されているリンク型のラックのいずれであっても、発射トリガを引くために必要とされる過剰量の力を伴わずに、比較的に大きな発射用の移動距離を可能にする多数回式の発射ストロークの能力を組み込んでいる。すなわち、これらの発射ストロークの間において、発射の後退用のバイアス力が不注意に発射の後退を生じないように、抗後退機構が組み込まれている。
多数回ストローク式の発射動作を行なうことが可能な、ハンドル20の利点は、図2〜図6において示されているエンド・エフェクタ12等のような器具を伴う、多数の器具への適用性を含む。特に、図4において、エンド・エフェクタ12は垂直方向に突出しているアンビルの特徴部分56(図4)に対して基端側にある一対の横方向に突出しているアンビル・ピボット・ピン54を含むアンビル基端部52に接続しているアンビル面50(図2、図4、図6)を最初に含むことによって、ハンドル20(図2〜図6においては図示せず)による閉鎖動作に応じて動作する。アンビル・ピボット・ピン54は細長い通路16に対してアンビル14を開閉させるためにその細長い通路16の中の腎臓形の開口部58の中で移動する。また、アンビルの特徴部分56は閉鎖チューブ24の先端部62におけるタブ孔60の中に内側に延在している屈曲タブ59(図2、図4、図6)に係合しており、この閉鎖チューブ24の先端部62はアンビル面50を押す先端側のエッジ部分64の中まで先端側に伸びている。これにより、閉鎖チューブ24がその開口位置から基端側に移動する時に、その閉鎖チューブ24の屈曲タブ59はアンビルの特徴部分56を基端側に引き動かして、アンビル・ピボット・ピン54は細長い通路16の腎臓形の開口部58に追随して動き、アンビル14を同時に基端側に移動させて、その開口位置まで上方に回転させる。その後、閉鎖チューブ24が先端側に移動すると、タブ孔60の中の屈曲タブ59はアンビルの特徴部分56から離れて、先端側のエッジ部分64はアンビル面50を押して、アンビル14を閉じる。
図7および図8において、外科ステープル用および切断用の器具10のハンドル20が詳細に示されていて、高められた強度、減少されたハンドルの寸法、最小化された拘束等のような、特徴を与えているリンク型の伝動発射機構150が例示されている。
特に、図10において、多数の利点を示すために、リンク型ラック200がさらに詳細に示されている。各リンク196a〜dはピストル・グリップ36の中への下方の基端側の回転のためにそれぞれの隣接しているリンク196a〜dに対してピン留めされている。なお、上述の方向に屈曲可能であるが、このリンク型ラック200は、円柱方向の負荷、特に、先端側の各リンク196a〜dを上方に押し曲げようとする負荷に対して、剛性の構造を形成する。特に、それぞれのリンク196a〜dは下側の部分において横方向の貫通穴302を有するオス形の延伸部分300の中に基端側に伸びている。それぞれのリンク196a〜dにおける左側の部分304は歯付きの表面部分222を含み、この左側の部分304と平行な右側の部分306はこれらの間に、オス形の延伸部分300の中に伸びている傾斜した中央トラック282、を定めている。
図11〜図14において、リンク型伝動発射機構150はシーケンスにおいて示されており、このシーケンスは上記の牽引バイアス機構210(すなわち、爪270、バイアス・ホイール278、およびバイアス・ランプ280)が発射トリガ34の移動方向に確実に応じる様式を示している。さらに、バイアス・ホイール278はバイアス・ランプ280に対して摩擦を伴って接触するので、このバイアス・ホイール278は爪270の完全な脱離または係合が達成される時に摺動する。
上述のように、抗後退機構250は、発射距離の移動が達成されるか使用者が後退することを選択するまで、発射ストロークの間ロックし、発射ロッド32、したがって、発射機構150が後退することを阻止する。図15において、抗後退機構250はロックされている状況で示されている。この場合に、抗後退解除レバー248は最も基端側の位置にあり、最小限の縦方向の長さを形成して、抗後退・プレート266のための増大された空間部分を作るために、抗後退・カム・チューブ268に係合するように、抗後退・カム・スロット・チューブ252を回転させている。この抗後退プレート266は抗後退圧縮ばね264により示されている角度で後方に傾けられており、図16において示されているように、発射ロッド32を把持している。
図26において、外科ステープル用および切断用の器具10はその初期的な開口状態にあり、閉鎖トリガ26および発射トリガ34は共に前方にあって、リンク型ラック200は後退している。上述のように、この無発射状態において、指示歯車230はその円形の隆起部242における開口部240をロッキングアーム172の上側の面部244に対応して配置しており、このロッキングアーム172は通常においてハウジング構造体182と閉鎖解除ボタン38の中間の先端面178との間において圧縮ばね180の作用により開口部240から下方に回転される。図26においては、閉鎖解除ボタン38は押されていて、上側の面部244は開口部240の中に入っている。さらに、図27において、閉鎖トリガ26およびロッキングアーム172は、この閉鎖トリガ26がピストル・グリップ36に対して押されて、発射トリガ34が発射のための位置に回転した後に、クランプしている状態で接触する。この場合に、伸ばされている閉鎖ばね180により分かるように、閉鎖解除ボタン38は押されていない。この結果、ロッキングアーム172の上側の面部244は円形の隆起部242の下方に回転しており、指示歯車230は解放されて反時計方向に自由に回転する。このロッキングアーム172の下方への移動は指示歯車230、したがって、リンク型伝動発射機構150を解放して、発射トリガ34が作動することを可能にする。このようにして、指示歯車230がその後の発射と共に回転し続けている時に、閉鎖解除ボタン38はクランプされている閉鎖トリガ26を解除することを妨げられている。
図28において、外科ステープル用および切断用の器具610はどちらかの手により容易に作動できる差込式の発射レトラクタとして機能する上部において接触可能な後退レバー642を提供するために上方に伸ばされている代替的な指示装置640により置き換えられている指示後退ノブを有している。この器具610は、先端側に前方の閉鎖トリガ26および発射トリガ34および開口状態のエンド・エフェクタ12により示されているように、開かれた無発射状態で示されている。発射が開始されていない場合に、後退レバー642は通常においてハンドル・ハウジング154に近接して先端側に回転されている。この指示装置640は、既に説明されているように、前述の遊び歯車220および発射機構150に連結可能であり(図示されていない)、この場合に、後退レバー642はリンク型伝動機構150が発射される時に基端側に回転して、その発射の視覚的な指示を行なうと共に、回転式の位置指示装置としてこれに手動による先端方向の力を加えることにより自動的な後退を補助する手段を可能にしている。なお、この様式においては、指示装置640は遊び歯車220に取り付けられることが必要であるので、その回転の方向を逆にする必要がある。
図31および図32において、外科ステープル用および切断用の器具1010は多数回のストロークの発射距離の移動の終了時における自動式のナイフの後退機構を含んでいる。さらに、上述の有利な特徴がエンド・エフェクタにおいて維持されており、その特徴は、この例示的な様式においては、ステープル供給組立体1012である。特に、図31において、アンビル1014は細長い(ステープル)通路1016に対するその旋回式の取付部分の回りにおいて繰り返して開閉可能である。ステープル供給装置1012は基端側において細長い軸部1018に取り付けられていて、実行部分1022を形成している。このステープル供給組立体1012が閉じられると、実行部分1022は、外部において接続される操作用のハンドル1020によるトロカールを通る挿入に適している小さな断面積を示すようになる。
図33および図35において、抗後退機構1250は、組み合わせ式の引張/圧縮ばね1184が発射ストロークの間にリンク型ラック1200を後退させること、を阻止する。連結摺動チューブ1131は第1のリンク1196dに接触して、発射動作を伝達するために発射ロッド1032に接続している。発射ロッド1032はフレーム1028の基端部から基端側に延出して、抗後退・プレート1266の貫通穴1408を貫通している。この貫通穴1408は垂直方向に向けられると発射ロッド1032を摺動自在に受容するが、傾けられると拘束するような大きさに作られている。下側タブ取付部材1271はフレーム1028の基端部の下側リップ部分から基端側に延出して、抗後退・プレート1266の下側エッジ部分における孔1269を貫通している。この下側タブ取付部材1271は、抗後退・プレート1266が、発射ロッド1032が先端側に進行すると、垂直になり、発射ロッド1032が後退しようとすると、上部を後方に傾けて拘束状態になるように、フレーム1028に近い抗後退・プレート1266の下側の部分を引き動かす。抗後退圧縮ばね1264はフレーム1028の基端部により先端側において拘束されていて、抗後退・プレート1266の上部の部分に基端側において接触して、この抗後退・プレート1266にバイアス力を加えてロック状態にしている。
図31〜図41において、リンク開始型の自動式の後退機構1289は、完全な発射距離の終了時にナイフの後退を生じるために、外科ステープル用および切断用の器具1010に組み込まれている。この目的のために、先端側のリンク1196dは、この先端側のリンク1196dが閉鎖ヨーク1162の中に形成されているラック通路1291の中に進行する時に上方に突出するタング1290、を含んでいる。このタング1290は抗後退解除レバー1248における下部の基端側のカム1292を作動させるように整合されている(図40)。特に、図38および図39において、右側および左側の半分の外殻部分1156,1158の中に形成されている各構造体は抗後退解除レバー1248の移動を拘束する。この場合に、右側および左側の半分の外殻部分1156,1158の間にそれぞれ形成されているピン・レセプタクル1296および円形のピン1293は下部の基端側のカム1292に対して先端側の抗後退解除レバー1248の中に形成されている縦方向に細長い孔1294を通して受容されており、これにより、縦方向の移動ならびに円形のピン1293の回りの回転を可能にしている。右側の半分の外殻部分1156の中において、基端側に開口している通路1295は、抗後退解除レバー1248の基端部の近くにおける右側後部のピン1297(図39)を受容している上方および先端側に曲げられている部分1295b、に連絡している基端側の水平な部分1295a、を含んでおり、これにより、抗後退解除レバー1248がその移動の最も先端側の部分に到達する時に、上方への回転を与える。また、抗後退解除レバー1248の基端側における右側の半分の外殻部分1156の中に形成されている遮断用の構造1333は、基端側に開口している通路1295の中に右側後部のピン1297を保持するために組み立てられていると、抗後退解除レバー1248の基端側への移動を阻止する。
図31〜図41において、代替の外科ステープル用および切断用の器具1010は発射トリガ1034を、図1〜図31における様式とは異なる様式で、リンク型ラック1200に連結させている。特に、図32〜図37において、発射トリガ1034はハウジング1154に接続されている発射トリガ・ピン1202の回りに旋回する。この発射トリガ1034の上側の部分1204は、発射トリガ1034がピストル・グリップ1036に向けて押されると、発射トリガ・ピン1202の回りに先端側に移動し、この発射トリガ1034の上側の部分1204とハウジング1154との間において基端側に接続されている基端側に配置されたトリガ引張ばね1206(図33)を伸ばす。また、発射トリガ1034の上側の部分1204は、発射トリガ1034が解放される時にはずれるばねバイアス型の側方の爪機構1210により、それぞれの発射トリガの押し込み中に、リンク型ラック1200に係合する。
図33、図35、および図42〜図47において、外科ステープル用および切断用の器具1010の第2の様式は、発射位置の指示と、発射機構の手動による解除と、手動式の後退と、を提供する代替の手動式の後退機構1500、を含み、さらに、一例の様式(図48〜図54)においては、完全な発射距離の移動の終了時において、自動式の後退をさらに行なう。特に、図33、図42および図43において、歯車機構1502は発射距離の移動の進行を視覚的に示して、ナイフを手動により後退させるために機能する。遊び歯車1220はリンク型ラック1200の歯付きの上側で左側の表面部分1222に係合している(図33、図44〜図46)。また、この前方の遊び歯車1220は、比較的に小さい右側のラチェット歯車1231を有している後部の遊び歯車1230にも係合している。これらの前方の遊び歯車1220および後部の遊び歯車1230は共に、それぞれ、前方のアイドラ軸1232および後部のアイドラ軸1234の上において、ハンドル・ハウジング1154に回転可能に接続されている。さらに、後部の軸1234のそれぞれの端部はそれぞれの右側および左側のハウジングの半分の外殻部分1156,1158を貫通しており、これらの端部は右側および左側の指示ゲージ・ホイール1040,1041に取り付けられている。さらに、後部の軸1234はハンドル・ハウジング1154の中において自由に回転して、後部の歯車1230に対してキー型の係合状態を有しているので、指示ゲージ・ホイール1040,1041は後部の歯車1230と共に回転する。この場合に、リンク型ラック1200と、遊び歯車1220と、後部の歯車1230と、の歯車の関係は、歯付きの上側の表面部分1222が、適当に丈夫で、リンク型伝動発射機構1150の完全な発射距離の移動の間に後部の歯車1230が1回よりも少ない回転を行なう歯の寸法を、有するように、好都合に選択できる。
図48〜図54において、外科ステープル用および切断用の器具1010aのための代替の自動式の後退機構1600は、3回の発射ストロークに相当するほとんど完全な回転の後に遮断部材1608に出会うまで、カム・ホイール1606の中の円形の溝1604の中において移動する歯1602を有する前方の遊び歯車1220aの中へ完全な発射距離の移動の終了時における自動式の後退機能を組み込んでいる。この場合に、右側の隆起部1610は、抗後退解除レバー1248aを先端側に移動させるために、上方に回転されて、下部のカム凹部1612に接触する。
(1)外科器具において、
外科手術を行なうために、縦方向の発射動作に応じるエンド・エフェクタと、
前記エンド・エフェクタに接続されている軸部と、
前記エンド・エフェクタに発射の動作を伝達するために、無発射の位置と完全に発射されている位置との間において、前記軸部により摺動自在に受容されている発射部材と、
前記発射部材を、前記軸部を通して進行させるために、複数の発射ストロークに応じる発射機構と、
前記軸部から基端側に離す方向のバイアス力を前記発射部材に加える、後退用のばねと、
前記発射部材の基端側への移動に応じてその発射部材に係合可能な抗後退機構と、
前記発射部材が完全に発射距離を移動した時に、前記抗後退機構を離脱状態でロックするように、操作可能に構成されている抗後退解除機構と、
を備えている、外科器具。
(2)実施態様1に記載の外科器具において、
前記抗後退機構が、
前記発射部材の周りを囲っている孔を含むロッキングプレートであって、その孔が前記発射部材にロックしながら係合するロックの位置と、その孔が前記発射部材に摺動自在に係合する解放の位置と、の間において、旋回可能である、ロッキングプレートと、
前記ロッキングプレートに、前記ロックの位置に向けて、バイアス力を加えている抗後退ばねと、
前記抗後退ばねのバイアス力に対抗するように置かれている抗後退解除レバーと、を含んでいる、外科器具。
(3)実施態様1に記載の外科器具において、
前記ハンドルが先端側に進行した閉鎖ヨークにより、発射ストロークの間に、前記エンド・エフェクタを閉鎖状態に保持するように、操作可能に構成されており、
この閉鎖ヨークが、前記抗後退機構を解除するために解放される時に、整合される解除の特徴部を含んでいる、外科器具。
(4)実施態様1に記載の外科器具において、
ハンドルをさらに備えており、
前記発射部材が、そのハンドルの中に収容されていて前記後退用のばねに取り付けられているラック、を含んでおり、
前記抗後退解除機構が、当該抗後退解除機構を先端側に移動させるために、前記ラックに連結されている、外科器具。
(5)実施態様4に記載の外科器具において、
前記抗後退解除部材が、先端部および基端部を有する抗後退解除レバーを備え、
この抗後退解除レバーは、前記基端部が先端側に動かされるのに応じて、前記先端部が先端側および下方に移動して前記抗後退機構に接触するように、前記ハンドルの中に拘束されている、外科器具。
前記ラックが、前記抗後退解除レバーの基端部を先端側に移動するように整合される、基端側に置かれているタング、を含んでいる、外科器具。
(7)実施態様5に記載の外科器具において、
前記ラックに連結されていて、そのラックの完全な発射距離の移動に応じて、カムを回転させて、当該カムを先端側に移動させて前記抗後退解除レバーの基端部に接触させるように、操作可能に構成されている歯車機構、をさらに備えている、外科器具。
(8)実施態様7に記載の外科器具において、
前記歯車機構は、前記ラックに係合していて、そのラックの完全な発射距離の移動に応じて1回転するような大きさに作られている遊び歯車、を含んでおり、前記抗後退解除レバーを先端側に移動させるために、前記遊び歯車に応じる前記カムを収容しているカム・ホイールを含んでいる、外科器具。
(9)実施態様4に記載の外科器具において、
前記エンド・エフェクタが
前記軸部に接続されている細長い通路と、
組織をクランプするために、前記細長い通路に旋回可能に連結されているアンビルと、
前記細長い通路の中に受容されているステープル・カートリッジと、を含んでおり、
前記発射部材が、クランプされている組織の中にステープルを形成するために、前記ステープル・カートリッジを作動するように操作可能に構成されている発射バーの中に、先端側まで伸びている、外科器具。
(10)外科器具において、
外科手術を行なうために、縦方向の発射動作に応じるエンド・エフェクタであって、細長い通路と、組織をクランプするためにその細長い通路に旋回可能に連結されているアンビルと、その細長い通路の中に受容されているステープル・カートリッジと、を含んでいる、エンド・エフェクタと、
前記エンド・エフェクタの細長い通路に接続されている軸部と、
前記ステープル・カートリッジを作動させて、クランプされている組織を切断するように、前記エンド・エフェクタに発射の動作を伝達するために、前記軸部により摺動自在に受容されている発射部材と、
前記軸部から基端側に離す方向に前記発射部材にバイアス力を加える後退用のばねと、
発射トリガと、
前記発射トリガの複数の発射ストロークに応じて、前記発射部材の完全な発射距離の移動を行なうために、爪をその発射部材に選択的に係合させる発射機構と、
前記発射部材の基端側への移動に応じてその発射部材に係合可能な抗後退機構であって、
前記発射部材の周りを囲っている孔を含んでいるロッキングプレートであり、前記孔が前記発射部材にロックしながら係合するロックの位置と、その孔が前記発射部材に摺動自在に係合する解放の位置と、の間において、旋回可能である、ロッキングプレートと、
前記ロッキングプレートに、前記ロックの位置に向けて、バイアス力を加えている抗後退ばねと、
先端部および基端部を有することにより、前記抗後退ばねのバイアス力に対抗するように配置されている抗後退解除レバーであって、先端側に動かされているその基端部に応じて、その先端部が先端側および下方に移動して前記抗後退機構に接触するように、拘束されている、抗後退解除レバーと、
を備える、抗後退機構と、
前記発射部材が完全に発射距離を移動した時に、前記抗後退機構を離脱状態でロックするように、操作可能に構成されている抗後退解除機構と、を備えている、外科器具。
前記発射部材が、前記抗後退解除レバーの基端部を先端側に移動させるために整合される、基端側に置かれているタング、を含んでいる、外科器具。
(12)実施態様11に記載の外科器具において、
前記発射部材が、前記タングを収容しているラック、をさらに含んでいる、外科器具。
(13)実施態様12に記載の外科器具において、
下向きのグリップを有するハンドルをさらに含んでおり、前記ラックがその下向きのグリップの中に下方に屈曲可能なリンク型のラックをさらに含んでいる、外科器具。
(14)実施態様10に記載の外科器具において、
前記ラックに連結されていて、そのラックの完全な発射距離の移動に応じて、カム・ホイールを回転させて、これを先端側に移動させて前記抗後退解除レバーの基端部に接触させるように、操作可能に構成されている歯車機構、をさらに備えている、外科器具。
(15)実施態様10に記載の外科器具において、
前記発射部材がラックを含んでおり、前記外科器具が、前記ラックに連結されていて、そのラックの完全な発射距離の移動に応じて、カムを回転させて、これを先端側に移動して前記抗後退解除レバーの基端部に接触させるように、操作可能に構成されている歯車機構、をさらに備えている、外科器具。
前記歯車機構が、前記ラックに係合していて、そのラックの完全な発射距離の移動に応じて1回転するような大きさに作られている遊び歯車、を含んでおり、前記抗後退解除レバーを先端側に移動させるために、前記遊び歯車に応じる前記カムを収容しているカム・ホイールを含んでいる、外科器具。
(17)外科器具において、
ステープル供給組立体と、
前記ステープル供給組立体の細長い通路に接続されている軸部と、
前記ステープル供給組立体に発射の動作を伝達するために、前記軸部により摺動自在に受容されている発射部材と、
前記発射部材にバイアス力を加えて、前記軸部から基端側に離している後退用のばねと、
前記発射部材に対して非垂直的な接触の拘束状態に、バイアス力が加えられるロック部材を有する抗後退機構と、
前記抗後退機構のロック部材を、前記発射部材に対して垂直的な接触の無拘束状態に、移動させるために、位置決め可能な抗後退解除レバーと、
前記抗後退解除レバーの位置を定めるために、前記発射部材の完全な発射距離の移動に応じる発射機構と、を備えている、外科器具。
(18)実施態様17に記載の外科器具において、
前記発射部材がラックを含んでおり、前記外科器具が、前記ラックに連結されていて、そのラックの完全な発射距離の移動に応じて、カムを回転させて、これを先端側に移動して前記抗後退解除レバーの基端部に接触させるように、操作可能に構成されている歯車機構、をさらに備えている、外科器具。
(19)実施態様18に記載の外科器具において、
前記歯車機構が、前記ラックに係合していて、そのラックの完全な発射距離の移動に応じて1回転するような大きさに作られている遊び歯車、を含んでおり、さらに、前記抗後退解除レバーを先端側に移動させるために、前記遊び歯車に応じる前記カムを収容しているカム・ホイールを含んでいる、外科器具。
(20)実施態様17に記載の外科器具において、
抗後退解除レバーの移動を拘束するハンドルをさらに備えており、この抗後退解除レバーが先端部および基端部を有しており、この抗後退解除レバーが、先端側に動かされているその基端部に応じて、その先端部が先端側および下方に移動して前記抗後退機構に接触するように、拘束されており、前記発射部材が、前記抗後退解除レバーの基端部を先端側に移動させるために整合される、基端側に置かれているタングを収容しているラック、を含んでいる、外科器具。
前記先端側の部分が、先端側に移動する時に、圧縮ばねによりロック用の構造の中に下方に押し動かされる前方のピンを含んでおり、前記ハンドルが、先端側に進行している閉鎖ヨークと共に、発射ストロークの間に、ステープル供給組立体を閉鎖状態に保持するように、操作可能に構成されており、前記閉鎖ヨークが、前記ロック用の構造から前記前方のピンを持ち上げることにより前記抗後退機構を解除するために開放される時に、整合される解除用の特徴部分を含んでいる、外科器具。
Claims (9)
- 外科器具において、
外科手術を行なうために、縦方向の発射動作に応じるエンド・エフェクタと、
前記エンド・エフェクタに接続されている軸部と、
前記エンド・エフェクタに発射の動作を伝達するために、無発射の位置と完全に発射されている位置との間において、前記軸部により摺動自在に受容されている発射部材と、
前記発射部材を、前記軸部を通して進行させるために、複数の発射ストロークに応じる発射機構と、
前記軸部から基端側に離す方向のバイアス力を前記発射部材に加える、後退用のばねと、
前記発射部材の基端側への移動に応じてその発射部材に係合可能な抗後退機構と、
前記発射部材が完全に発射距離を移動した時に、前記抗後退機構を離脱状態でロックするように、操作可能に構成されている抗後退解除機構と、
を備えている、外科器具。 - 請求項1に記載の外科器具において、
前記抗後退機構が、
前記発射部材の周りを囲っている孔を含むロッキングプレートであって、その孔が前記発射部材にロックしながら係合するロックの位置と、その孔が前記発射部材に摺動自在に係合する解放の位置と、の間において、旋回可能である、ロッキングプレートと、
前記ロッキングプレートに、前記ロックの位置に向けて、バイアス力を加えている抗後退ばねと、
前記抗後退ばねのバイアス力に対抗するように置かれている抗後退解除レバーと、を含んでいる、外科器具。 - 請求項1に記載の外科器具において、
前記ハンドルが先端側に進行した閉鎖ヨークにより、発射ストロークの間に、前記エンド・エフェクタを閉鎖状態に保持するように、操作可能に構成されており、
この閉鎖ヨークが、前記抗後退機構を解除するために解放される時に、整合される解除の特徴部を含んでいる、外科器具。 - 請求項1に記載の外科器具において、
ハンドルをさらに備えており、
前記発射部材が、そのハンドルの中に収容されていて前記後退用のばねに取り付けられているラック、を含んでおり、
前記抗後退解除機構が、当該抗後退解除機構を先端側に移動させるために、前記ラックに連結されている、外科器具。 - 請求項4に記載の外科器具において、
前記抗後退解除部材が、先端部および基端部を有する抗後退解除レバーを備え、
この抗後退解除レバーは、前記基端部が先端側に動かされるのに応じて、前記先端部が先端側および下方に移動して前記抗後退機構に接触するように、前記ハンドルの中に拘束されている、外科器具。 - 請求項5に記載の外科器具において、
前記ラックが、前記抗後退解除レバーの基端部を先端側に移動するように整合される、基端側に配置されているタング、を含んでいる、外科器具。 - 請求項5に記載の外科器具において、
前記ラックに連結されていて、そのラックの完全な発射距離の移動に応じて、カムを回転させて、当該カムを先端側に移動させて前記抗後退解除レバーの基端部に接触させるように、操作可能に構成されている歯車機構、をさらに備えている、外科器具。 - 請求項7に記載の外科器具において、
前記歯車機構は、前記ラックに係合していて、そのラックの完全な発射距離の移動に応じて1回転するような大きさに作られている遊び歯車、を含んでおり、前記抗後退解除レバーを先端側に移動させるために、前記遊び歯車に応じる前記カムを収容しているカム・ホイールを含んでいる、外科器具。 - 外科器具において、
外科手術を行なうために、縦方向の発射動作に応じるエンド・エフェクタであって、細長い通路と、組織をクランプするためにその細長い通路に旋回可能に連結されているアンビルと、その細長い通路の中に受容されているステープル・カートリッジと、を含んでいる、エンド・エフェクタと、
前記エンド・エフェクタの細長い通路に接続されている軸部と、
前記ステープル・カートリッジを作動させて、クランプされている組織を切断するように、前記エンド・エフェクタに発射の動作を伝達するために、前記軸部により摺動自在に受容されている発射部材と、
前記軸部から基端側に離す方向に前記発射部材にバイアス力を加える後退用のばねと、
発射トリガと、
前記発射トリガの複数の発射ストロークに応じて、前記発射部材の完全な発射距離の移動を行なうために、爪をその発射部材に選択的に係合させる発射機構と、
前記発射部材の基端側への移動に応じてその発射部材に係合可能な抗後退機構であって、
前記発射部材の周りを囲っている孔を含んでいるロッキングプレートであり、前記孔が前記発射部材にロックしながら係合するロックの位置と、その孔が前記発射部材に摺動自在に係合する解放の位置と、の間において、旋回可能である、ロッキングプレートと、
前記ロッキングプレートに、前記ロックの位置に向けて、バイアス力を加えている抗後退ばねと、
先端部および基端部を有することにより、前記抗後退ばねのバイアス力に対抗するように配置されている抗後退解除レバーであって、先端側に動かされているその基端部に応じて、その先端部が先端側および下方に移動して前記抗後退機構に接触するように、拘束されている、抗後退解除レバーと、
を備える、抗後退機構と、
前記発射部材が完全に発射距離を移動した時に、前記抗後退機構を離脱状態でロックするように、操作可能に構成されている抗後退解除機構と、を備えている、外科器具。
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EP1690501B1 (en) | 2011-03-30 |
PL2263566T3 (pl) | 2019-05-31 |
HK1090822A1 (en) | 2007-01-05 |
EP1690501B2 (en) | 2014-12-10 |
CN1827052A (zh) | 2006-09-06 |
RU2419392C2 (ru) | 2011-05-27 |
EP2263566A3 (en) | 2014-09-24 |
ATE503424T1 (de) | 2011-04-15 |
EP2263566B1 (en) | 2018-12-12 |
KR101233999B1 (ko) | 2013-02-18 |
RU2006103353A (ru) | 2007-08-20 |
DE602006020945D1 (de) | 2011-05-12 |
MXPA06001424A (es) | 2006-09-19 |
US7083075B2 (en) | 2006-08-01 |
AU2006200288B2 (en) | 2011-10-06 |
CN100539954C (zh) | 2009-09-16 |
KR20060090188A (ko) | 2006-08-10 |
JP5154017B2 (ja) | 2013-02-27 |
AU2006200288A1 (en) | 2006-08-24 |
SG125182A1 (en) | 2006-09-29 |
BRPI0600240B1 (pt) | 2021-05-25 |
EP1690501A1 (en) | 2006-08-16 |
EP2263566A2 (en) | 2010-12-22 |
BRPI0600240A (pt) | 2006-10-03 |
US20050178813A1 (en) | 2005-08-18 |
CA2535224C (en) | 2013-04-23 |
CA2535224A1 (en) | 2006-08-07 |
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