JP2007075622A - 整合機構を備えたクリップアドバンサー機構 - Google Patents
整合機構を備えたクリップアドバンサー機構 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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
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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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
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- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/032—Automatic limiting or abutting means, e.g. for safety pressure limiting, e.g. hydrostatic
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Abstract
【解決手段】外科クリップアプライヤ10であって、トリガー16が移動可能に結合されたハウジング12と、ハウジングから延びた、遠位端部に対向した顎部20を備えたシャフト18を含む。トリガーは、クリップを前進させて顎部間に配置し、そして顎部を開位置から閉止位置に移動させて、顎部間に配置されたクリップを圧縮形成するように構成されている。外科クリップアプライヤは、クリップを顎部に整合させる機構、クリップの不所望の移動を防止する機構、および形成の際にクリップが落下するのを防止する機構を含め、装置の使用を容易にするための様々な機構を含むことができる。
【選択図】図1A
Description
本願は、2005年4月14日出願の米国特許出願第10/907,763号(名称:「外科クリップアプライヤの方法(Surgical Clip Applier Methods)」)、2005年4月14日出願の同第10/907,764号(名称:「医療器具用の力を制限する機構(Force Limiting Mechanism For Medical Instrument)」)、2005年4月14日出願の同第10/907,765号(名称:「外科クリップ前進機構(Surgical Clip Advancement Mechanism)」)、2005年4月14日出願の同第10/907,766号(名称:「外科クリップアプライヤのラチェット機構(Surgical Clip Applier Ratchet Mechanism)」)、および2005年4月14日出願の同第10/907,768号(名称:「外科クリップ前進/整合機構(Surgical Clip Advancement And Alignment Mechanism)」)の一部継続出願である。これらの特許出願は参照をもってその開示内容の全てを本明細書の一部とする。
本発明は、広義には外科装置に関し、詳細には、管、脈管、シャントなどに外科クリップを取り付けるための装置および方法に関する。
近年、胆嚢摘出術、胃瘻造設術、虫垂切除術、およびヘルニア修復術などの腹腔鏡外科手術および内視鏡外科手術の実施によって外科手術が著しく進歩した。このような外科手術は、体腔内に挿入するために用いられる外科器具であるトロカール組立体を介して行われる。このようなトロカールは、通常は、尖ったオブチュレータチップおよびトロカールチューブすなわちカニューレを含む。オブチュレータチップを用いて皮膚に刺入し、トロカールカニューレを、皮膚内に挿入して体腔内にアクセスする。挿入後、オブチュレータを取り外し、トロカールカニューレを体内に残す。このカニューレを介して、外科器具を配置する。
本発明は、血管、ダクト、シャントなどに外科クリップを取り付けるための方法および装置を提供する。例示的な一実施形態では、外科クリップアプライヤは、トリガーが移動可能に結合されたハウジングと、そのハウジングから延び、遠位端部に対向した顎部が形成されている細長いシャフトを有する外科クリップアプライヤを提供する。トリガーは、クリップを前進させて顎部間に配置し、顎部を開位置から閉止位置に移動させて、顎部間に配置されたクリップを圧縮形成するように構成されている。
本発明は、添付の図面を参照しながら以下の詳細な説明を読めば、より完全に理解できるであろう。
(1)外科クリップアプライヤにおいて、
近位端部および遠位端部を有するシャフトと、
前記シャフトの前記遠位端部に形成された対向した顎部と、
前記顎部に結合されたガイド部材であって、整合機構を備えており、この整合機構が、クリップを前記対向した顎部の中に誘導するとともに、前記クリップの対向した脚が閉じられる時に前記クリップと前記対向した顎部との整合を維持するように構成されている、ガイド部材と、
を含む、外科クリップアプライヤ。
(2)実施態様(1)に記載の外科クリップアプライヤにおいて、
前記整合機構が、前記対向した顎部の間で形成されたクリップの下面に当接して、前記クリップが垂直方向に旋回するのを防止するように構成されている、外科クリップアプライヤ。
(3)実施態様(1)に記載の外科クリップアプライヤにおいて、
前記ガイド部材が、血管を受容するための凹部が形成された遠位端部を有する組織ストッパーを含む、外科クリップアプライヤ。
(4)実施態様(3)に記載の外科クリップアプライヤにおいて、
前記整合機構が、前記組織ストッパーの上面から延出したランプ部材を含む、外科クリップアプライヤ。
(5)実施態様(4)に記載の外科クリップアプライヤにおいて、
前記ランプ部材の高さが、前記組織ストッパーの近位端部から遠位端部にかけて増大している、外科クリップアプライヤ。
前記シャフトに移動可能に結合され、かつ、前記ガイド部材の整合機構に対してクリップを前進させて、このクリップを前記対向した顎部間に配置するように構成されたアドバンサー、
をさらに含む、外科クリップアプライヤ。
(7)外科クリップアプライヤにおいて、
シャフトと、
前記シャフトの遠位端部に形成され、互いに閉じてクリップすべき組織を近接させるように構成された対向した顎部と、
前記シャフトに移動可能に結合され、クリップを前記対向した顎部の中に前進させるように構成されたクリップ前進組立体と、
前記対向した顎部のすぐ近位側に配置され、前記クリップ前進組立体によって前記対向した顎部の中に送られるクリップを誘導するように構成されたアドバンサーガイドと、
を含む、外科クリップアプライヤ。
(8)実施態様(7)に記載の外科クリップアプライヤにおいて、
前記アドバンサーガイドが、前記クリップを前記対向した顎部に整合させるように構成されている、外科クリップアプライヤ。
(9)実施態様(7)に記載の外科クリップアプライヤにおいて、
前記アドバンサーガイドが、前記対向した顎部に結合された組織ストッパーに形成されている、外科クリップアプライヤ。
(10)実施態様(9)に記載の外科クリップアプライヤにおいて、
前記組織ストッパーが、その遠位端部に形成され、組織を受容するように構成された凹部を含む、外科クリップアプライヤ。
前記アドバンサーガイドが、前記組織ストッパーの近位面の上に延出したランプ部材を含む、外科クリップアプライヤ。
(12)互いに閉じてクリップすべき組織を近接させる顎部、および複数のクリップを前記顎部の中に連続的に前進させるように構成されたクリップ前進組立体を有する、改善された内視鏡外科クリップアプライヤにおいて、
ランプガイド部材であって、前記対向した顎部のすぐ近位端側に配置され、かつ、前記クリップ前進組立体によって前記対向した顎部の中に送られるクリップを整合させて誘導し、前記クリップが前記対向した顎部の間で形成される際に前記クリップの垂直方向の移動を防止するように構成された、ランプガイド部材、
をさらに含む、外科クリップアプライヤ。
(13)実施態様(12)に記載の外科クリップアプライヤにおいて、
前記ランプガイド部材が、前記対向した顎部に結合された組織ストッパーに形成されており、この組織ストッパーが、内部に組織を受容してクリップすべき組織を前記顎部に整合させるように構成された遠位端部を含む、外科クリップアプライヤ。
(14)実施態様(12)に記載の外科クリップアプライヤにおいて、
前記ランプガイド部材の高さが、そのランプガイド部材の近位端部から遠位端部にかけて増大している、外科クリップアプライヤ。
(15)実施態様(12)に記載の外科クリップアプライヤにおいて、
前記ランプガイド部材が、0.635mm(0.025in)の最大高さを有する、外科クリップアプライヤ。
前記ランプガイド部材が、5度〜45度の範囲の角度で傾斜している、外科クリップアプライヤ。
Claims (8)
- 外科クリップアプライヤにおいて、
近位端部および遠位端部を有するシャフトと、
前記シャフトの前記遠位端部に形成された対向した顎部と、
前記顎部に結合されたガイド部材であって、整合機構を備えており、この整合機構が、クリップを前記対向した顎部の中に誘導するとともに、前記クリップの対向した脚が閉じられる時に前記クリップと前記対向した顎部との整合を維持するように構成されている、前記ガイド部材と、
を含む、外科クリップアプライヤ。 - 請求項1に記載の外科クリップアプライヤにおいて、
前記整合機構が、前記対向した顎部の間で形成されたクリップの下面に当接して、前記クリップが垂直方向に旋回するのを防止するように構成されている、外科クリップアプライヤ。 - 請求項1に記載の外科クリップアプライヤにおいて、
前記ガイド部材が、血管を受容するための凹部が形成された遠位端部を有する組織ストッパーを含む、外科クリップアプライヤ。 - 請求項3に記載の外科クリップアプライヤにおいて、
前記整合機構が、前記組織ストッパーの上面から延出したランプ部材を含む、外科クリップアプライヤ。 - 請求項4に記載の外科クリップアプライヤにおいて、
前記ランプ部材の高さが、前記組織ストッパーの近位端部から遠位端部にかけて増大している、外科クリップアプライヤ。 - 請求項1に記載の外科クリップアプライヤにおいて、
前記シャフトに移動可能に結合され、かつ、前記ガイド部材の整合機構に対してクリップを前進させて、このクリップを前記対向した顎部間に配置するように構成されたアドバンサー、
をさらに含む、外科クリップアプライヤ。 - 外科クリップアプライヤにおいて、
シャフトと、
前記シャフトの遠位端部に形成され、互いに閉じてクリップすべき組織を近接させるように構成された対向した顎部と、
前記シャフトに移動可能に結合され、クリップを前記対向した顎部の中に前進させるように構成されたクリップ前進組立体と、
前記対向した顎部のすぐ近位側に配置され、前記クリップ前進組立体によって前記対向した顎部の中に送られるクリップを誘導するように構成されたアドバンサーガイドと、
を含む、外科クリップアプライヤ。 - 互いに閉じてクリップすべき組織を近接させる顎部、および複数のクリップを前記顎部の中に連続的に前進させるように構成されたクリップ前進組立体を有する、改善された内視鏡外科クリップアプライヤにおいて、
ランプガイド部材であって、前記対向した顎部のすぐ近位端側に配置され、かつ、前記クリップ前進組立体によって前記対向した顎部の中に送られるクリップを整合させて誘導し、前記クリップが前記対向した顎部の間で形成される際に前記クリップの垂直方向の移動を防止するように構成された、ランプガイド部材、
をさらに含む、外科クリップアプライヤ。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/162,588 US8523882B2 (en) | 2005-04-14 | 2005-09-15 | Clip advancer mechanism with alignment features |
US11/162,588 | 2005-09-15 |
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JP2007075622A true JP2007075622A (ja) | 2007-03-29 |
JP5042572B2 JP5042572B2 (ja) | 2012-10-03 |
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JP2006249658A Active JP5042572B2 (ja) | 2005-09-15 | 2006-09-14 | 整合機構を備えたクリップアドバンサー機構 |
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US (1) | US8523882B2 (ja) |
EP (1) | EP1764043B1 (ja) |
JP (1) | JP5042572B2 (ja) |
KR (1) | KR101296092B1 (ja) |
CN (1) | CN100589774C (ja) |
AT (1) | ATE544405T1 (ja) |
AU (1) | AU2006213958B2 (ja) |
BR (1) | BRPI0604715B8 (ja) |
CA (1) | CA2560139C (ja) |
HK (1) | HK1100161A1 (ja) |
MX (1) | MXPA06010634A (ja) |
RU (1) | RU2435535C2 (ja) |
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JP2020501794A (ja) * | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | 外科用器具シャフトのヒューズをリセットする方法 |
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- 2006-09-14 EP EP06254793A patent/EP1764043B1/en active Active
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JP2020501794A (ja) * | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | 外科用器具シャフトのヒューズをリセットする方法 |
JP7039597B2 (ja) | 2016-12-21 | 2022-03-22 | エシコン エルエルシー | 外科用器具シャフトのヒューズをリセットする方法 |
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SG131069A1 (en) | 2007-04-26 |
CA2560139C (en) | 2014-06-10 |
EP1764043B1 (en) | 2012-02-08 |
AU2006213958A1 (en) | 2007-03-29 |
US20060235444A1 (en) | 2006-10-19 |
BRPI0604715A (pt) | 2007-08-28 |
EP1764043A2 (en) | 2007-03-21 |
RU2435535C2 (ru) | 2011-12-10 |
KR20070031824A (ko) | 2007-03-20 |
AU2006213958B2 (en) | 2013-05-23 |
KR101296092B1 (ko) | 2013-08-19 |
EP1764043A3 (en) | 2009-03-18 |
US8523882B2 (en) | 2013-09-03 |
MXPA06010634A (es) | 2007-03-30 |
HK1100161A1 (en) | 2007-09-07 |
BRPI0604715B8 (pt) | 2021-06-22 |
JP5042572B2 (ja) | 2012-10-03 |
ATE544405T1 (de) | 2012-02-15 |
CA2560139A1 (en) | 2007-03-15 |
BRPI0604715B1 (pt) | 2018-05-29 |
CN100589774C (zh) | 2010-02-17 |
RU2006133130A (ru) | 2008-03-20 |
CN1994237A (zh) | 2007-07-11 |
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