JP2007125397A - 医療用薬剤を送る構造となっている手術用ステープル留め器械 - Google Patents
医療用薬剤を送る構造となっている手術用ステープル留め器械 Download PDFInfo
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Abstract
【課題】組織を切断し、ステープル留めするように設計された手術用切断／ステープル留め器械と共に使用するような構造にすることができる医療用薬剤投薬システムを提供する。
【解決手段】投薬システムは、少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器と、貯蔵容器とつながっているギアポンプ用ケーシングと、ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、ギアポンプ用ケーシングを介して医療用薬剤を移動させるために、回転操作できるスクリューポンプ用らせん状部と、ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブとを有していてもよい。薬剤チューブは、手術用器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポートと、薬剤ポートを介して医療用薬剤を投薬するためにつながっている。
【選択図】図１
【解決手段】投薬システムは、少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器と、貯蔵容器とつながっているギアポンプ用ケーシングと、ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、ギアポンプ用ケーシングを介して医療用薬剤を移動させるために、回転操作できるスクリューポンプ用らせん状部と、ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブとを有していてもよい。薬剤チューブは、手術用器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポートと、薬剤ポートを介して医療用薬剤を投薬するためにつながっている。
【選択図】図１
Description
〔発明の分野〕
本発明は、概して、手術用器械に関するものである。本発明は、より詳細には、手術用器械の使用に伴い医療用薬剤を送りかつ塗布して、切断され、ステープル留めされた組織の閉鎖および治癒を促進することに関するものである。
本発明は、概して、手術用器械に関するものである。本発明は、より詳細には、手術用器械の使用に伴い医療用薬剤を送りかつ塗布して、切断され、ステープル留めされた組織の閉鎖および治癒を促進することに関するものである。
〔背景〕
従来の手術用ステープラーであって、組織を縦に切開することと、その切開部の両側にステープルの列を加えることを同時に行うのに使用できるものは、当該技術において公知である。このような器械は、一対の協同するあご部材を含み、この一対のあご部材は、内視鏡下または腹腔鏡下の応用に利用される場合、カニューレの通路を通過することができる。あご部材の１つには、通常、ステープル・カートリッジが入れられ、このステープル・カートリッジは、少なくとも２つの横方向に間隔をあけたステープルの列を有する。他方のあご部材は、アンビルを画定しており、このアンビルはステープル成形用ポケットを有しており、これらのポケットは、カートリッジにあるステープル列に対応するように位置が合わせてある。このようなステープル留め器械は、複数の往復運動を行うくさび部をも含んでいてもよく、これらのくさび部は、駆動されたときに、ステープル・カートリッジにある開口部を通過し、ステープルを支持している駆動体に係合して、ステープルをアンビルの方へ発射し、組織に通す。
従来の手術用ステープラーであって、組織を縦に切開することと、その切開部の両側にステープルの列を加えることを同時に行うのに使用できるものは、当該技術において公知である。このような器械は、一対の協同するあご部材を含み、この一対のあご部材は、内視鏡下または腹腔鏡下の応用に利用される場合、カニューレの通路を通過することができる。あご部材の１つには、通常、ステープル・カートリッジが入れられ、このステープル・カートリッジは、少なくとも２つの横方向に間隔をあけたステープルの列を有する。他方のあご部材は、アンビルを画定しており、このアンビルはステープル成形用ポケットを有しており、これらのポケットは、カートリッジにあるステープル列に対応するように位置が合わせてある。このようなステープル留め器械は、複数の往復運動を行うくさび部をも含んでいてもよく、これらのくさび部は、駆動されたときに、ステープル・カートリッジにある開口部を通過し、ステープルを支持している駆動体に係合して、ステープルをアンビルの方へ発射し、組織に通す。
内視鏡下の応用での利用に適している手術用ステープラーの例は、米国特許出願第ＵＳ２００４／０２３２１９６ Ａ１に記載されている。手術用ステープラーの操作では、臨床医がステープラーのあご部材を組織の上に閉じる、すなわち、組織をクランプ締めして、ステープラーの作動の前、すなわち、動かす前に組織を位置決めする。いったん臨床医が、あご部材が組織を所望の位置でクランプ締めしていることを確認したら、次に手術用ステープラーを臨床医が作動して、組織に切開部を造り、同時にその切開部を囲んでいる組織をステープル留めすることができる。このようにステープラーが同時に作動するので、切断操作とステープル留め操作が順に（または異なるときに）異なる手術工具で行う（つまり、１つの装置が組織を切断するのに用いられ、そして次に別の装置が組織をステープル留めするのに用いられる）場合によく起こる煩雑さを防ぐ。
一般に、所定の医療用薬剤を組織の切開部に塗ると、治癒を促進でき、感染の可能性を減らすことができ、および／または、切開の適切な密閉を促進する。このような医療用薬剤の作用の助けがある場合、多くの手術用ステープラーは、治癒の向上、耐感染性の改善、および、組織切開部の密封向上に関してよりよい手術の成果を達成しうる。しかし、数多くの従来の手術用ステープラーの構造、および、このようなステープラーが利用される手技は、医療用薬剤または医療用薬剤を投薬するシステムの利益に影響を与えない。
上記に鑑みて、手術用ステープラーを伴う手術中に切断され、ステープル留めされた組織の切開部の閉鎖、治療、および、治癒をより効果的かつ効率的に促進する改良型手術用器械および医療用薬剤投薬システムが必要である。
〔概要〕
本発明によれば、医療用薬剤投薬システムのさまざまな実施形態が提供されうる。医療用薬剤投薬システムは、組織を切断し、ステープル留めする構造となっている手術用切断／ステープル留め器械とともに使用する構造となっていてもよい。投薬システムは、以下のものを含んでもよい：少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器；貯蔵容器とつながっているギアポンプ用ケーシング；ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、ギアポンプ用ケーシングを介して医療用薬剤を移動させるために、回転操作できるスクリューポンプ用らせん状部；および、ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブ。薬剤用チューブは、手術用器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポートと、前記薬剤ポートを介して医療用薬剤を投薬するためにつながっている。
本発明によれば、医療用薬剤投薬システムのさまざまな実施形態が提供されうる。医療用薬剤投薬システムは、組織を切断し、ステープル留めする構造となっている手術用切断／ステープル留め器械とともに使用する構造となっていてもよい。投薬システムは、以下のものを含んでもよい：少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器；貯蔵容器とつながっているギアポンプ用ケーシング；ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、ギアポンプ用ケーシングを介して医療用薬剤を移動させるために、回転操作できるスクリューポンプ用らせん状部；および、ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブ。薬剤用チューブは、手術用器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポートと、前記薬剤ポートを介して医療用薬剤を投薬するためにつながっている。
本発明によれば、医療用薬剤投薬システムを含む手術用切断／ステープル留め器械のさまざまな実施形態が提供されうる。手術用器械は、少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器を含むハンドル部分と、ハンドル部分に連結されているシャフト部分とを含んでいてもよい。シャフト部分は、貯蔵容器とつながっているギアポンプ用ケーシングを含んでいてもよく、ギアポンプ用ケーシングは、スクリューポンプ用らせん状部を含み、スクリューポンプ用らせん状部は、ギアポンプ用ケーシングを通って延びており、ギアポンプ用ケーシングを介して医療用薬剤を移動させるために回転操作可能である。手術用器械は、シャフト部分に機能的に結合されているエンド・エフェクター部分であって、ステープル・カートリッジが中に取り外し可能に配置されているエンド・エフェクター部分をさらに有していてもよい。少なくとも１つの薬剤チューブが、ギアポンプ用ケーシングとつながった状態で設けられていてもよい；そして、薬剤チューブは、シャフト部分から延びていて、手術器械のステープル・カートリッジに形成された少なくとも１つの薬剤ポートとつながっていてもよい。薬剤ポートは、薬剤ポートを介して医療用薬剤が投薬されることが可能であるような構造となっていてもよい。
添付図面は、本明細書に組み込まれ、本明細書の一部を構成するものであり、本発明の実施形態を示している。本明細書に用意された実施形態の記載とともに、図面は、本発明の原理を当業者に対して説明するものである。
〔説明〕
本明細書で用いる場合、用語「組織」には、さまざまな種類の人間もしくは動物の組織、膜、または、他の有機基質が含まれうる。用語「組織」には、本明細書に記載された手術用ステープル留め／切断器械のさまざま実施形態で切断およびステープル留めされうる任意の物質、基質、または、合成物も含まれうる。
本明細書で用いる場合、用語「組織」には、さまざまな種類の人間もしくは動物の組織、膜、または、他の有機基質が含まれうる。用語「組織」には、本明細書に記載された手術用ステープル留め／切断器械のさまざま実施形態で切断およびステープル留めされうる任意の物質、基質、または、合成物も含まれうる。
本明細書で用いる場合、用語「医療用薬剤」には、さまざまな種類の化学薬品、液体、高粘性流体、粉末または組織に塗布できる他の合成物が含まれうる。「医療用薬剤」の例は、限定はしないが、止血剤、治癒剤、接着剤、密封剤、抗菌剤、抗感染剤、鎮痛剤、および、さまざまな他の種類の薬用または有用な物質を含む。
図面を概略的に参照し、かつ、本発明のさまざまな実施形態に関連していうと、手術用切断／ステープル留め器械１０は、実行部分２２に接続されているハンドル部分２０を用いて構成されることができる。この実行部分２２は、シャフト２４を含んでいてもよく、シャフト２４は、ハンドル部分２０から遠位へ延び、末端がエンド・エフェクター２６となっている。エンド・エフェクター２６は、アクチュエータ、すなわち、Ｅ字状ビーム発射機構（「発射バー(firing bar)」）２８を有することであってもよく、このＥ字状ビーム発射機構２８は、エンド・エフェクター２６に入っている細長いチャネル３０と、軸周りに動かせるアンビル３２との間の間隔を調整する。見て分かるように、チャネル３０とアンビル３２の間隔は、例えば臨床医が手術用器械１０を使っている間に、組織のステープル留めおよび切断をより効率的に行えるように構成されることができる。
器械１０のハンドル部分２０は、ピストル型グリップ部３４を有していてもよく、このピストル型グリップ部３４の方へ、例えば臨床医が、締め付け用引き金３６を軸回転させるように引いて、アンビル３２をエンド・エフェクター２６のチャネル３０の方へクランプ締めする、すなわち、閉じることであってもよい。手術中、例えば患者の組織を、アンビル３２をチャネル３０の方へ閉じることによりクランプ締めすることができる。締め付け用引き金３６の近傍に配置された発射用引き金３８は、ピストル型グリップ部３４の方向に軸回転するように引いて、器械１０のエンド・エフェクター２６にクランプ締めされている組織を実質的に同時にステープル留めおよび切断することができる。外科手術では、臨床医がまず締め付け用引き金３６を動かし、例えば患者の組織をクランプ締めする。臨床医がエンド・エフェクター２６の配置に満足したら、締め付け用引き金３６を、ピストル型グリップ部３４のすぐ近くの最大限閉じられていて、かつ、ロックされている位置まで引くことができる。次に、器械１０の発射用引き金３８を動かして、クランプ締めした組織を切断およびステープル留めすることができる。発射用引き金３８は、臨床医が発射用引き金３８に加えている圧力を取り去ると、通常の、動かされていない状態にはね戻ることができる。ハンドル部分２０の近位端に配置されているリリースボタン４０を臨床医が押して、ロックされている締め付け用引き金３６を（図１に示したような）その通常の開いた位置まで解放することもできる。
さまざまな実施形態において、シャフト２４の遠位端は、締めつけ管５２を有していてもよく、この締めつけ管５２は、アンビル３２およびチャネル３０のような、エンド・エフェクター２６の部品の一部を入れて収めるような構造となっている。締めつけ管５２は、締めつけ管５２を通って延びるスパイン(spine)５４を受け入れる構造となっていてもよい。スパイン５４は、ナイフシャフト５６を支持しており、このナイフシャフトは、遠位に配置された切断用エッジ５８を有している。ナイフシャフト５６は、ナイフシャフト５６の切断用エッジ５８において、発射バー２８と、適切に作用するように相互作用することができる。ナイフスプリング６０がスパイン５４の中に挿入されてもよく、このナイフスプリング６０は、弾性的な下方の付勢力を有するような構造となっていて、この付勢力によりナイフシャフト５６がスパイン５４内により適切、かつ、よりしっかりと固定されて配置されることであってもよい。手術中、器械１０が作動されると、ナイフシャフト５６およびナイフシャフト５６の切断用エッジ５８が、ナイフロッド６１により、チャネル３０の端から端まで動かされ、アンビル３２とチャネル３０の間にクランプ締めされている組織を切断する。チャネル３０は、チャネル３０の中に、取り外し可能なステープル・カートリッジ６２を入れられる構造となっていてもよい。ステープル・カートリッジ６２は、複数のステープル用孔部（例えば、説明用の典型的なステープル用孔部６４、６６、６８など）を有することであってもよい。このステープル用孔部は、ステープル・カートリッジ６２の中に形成されていて、器械１０が作動されたときに、このステープル用孔部を通して複数のステープル（不図示）を打ち込むことができ、これにより、切断された組織をステープル留めする。特定の実施形態では、ステープル・カートリッジ６２が、例えば、オハイオ州シンシナティーのエチコン・エンド−サージェリー社（Ethicon Endo-Surgery, Inc., of Cincinnati, Ohio）により市場に出されている「ＥＴＳ４５」または「ＥＴＳ６０」という６列式カートリッジであってもよい。
本発明の実施形態とともに提供されうる典型的な手術用ステープル留め器械の構造および動作の例は、シェルトンら(Shelton et al)の米国で公開された特許出願であって、発明の名称が「別個で異なる閉鎖システムと発射システムを有する手術用ステープル留め器械」（米国公開番号第２００４／０２３２１９６、出願番号第１０／４４１、６３２号、２００３年５月２０日出願）であるものに開示されており、この出願は、全て、参照によりここに組み入れる。
手術器械１０といっしょに提供できる医療用薬剤投薬システムの実施形態に関しては、ポンプ用らせん状部のケーシング７２がスパイン５４を通って長さ方向に延びるように配置されてもよく、また、器械１０のハンドル部分２０から横向きマニホールド７４まで延びていてもよい。ポンプ用らせん状部のケーシング７２は、スクリューポンプ用らせん状部７６がケーシング７２の端から端まで入るような構造になっていてもよく、そのスクリューポンプ用らせん状部７６は、ポンプ用らせん状部のケーシング７２内に配置されたときに、回転操作することができる。図６は、本発明のさまざまな実施形態にしたがって使用することができるスクリューポンプ用らせん状部７６の例を示す。１つ以上の薬剤用チューブ７８、８０を、横向きマニホールド７４と、カートリッジ６２のステープル用孔部６４、６６、６８にほぼ隣接するようにステープル・カートリッジ６２に形成された複数の薬剤用ポート（例えば、説明用の代表的な薬剤用ポート８２、８４、８６など）との両方とつながるように配置されてもよい。薬剤チューブ７８、８０は、図８におけるカートリッジ６２の端面図に示されているように、ステープル・カートリッジ６２内の薬剤ポート８２、８４、８６とつながるような構造となっていてもよい。薬剤ポートの列８２、８４、８６が、チャネル３０の長さ方向中心軸の両側の隣に配置されているのが示されているが、当然ながら、このような薬剤ポート８２、８４、８６をもっと多くまたはもっと少なくカートリッジ６２に設けてもよい。例えば、もっと多くの薬剤ポート８２、８４、８６を、図示のようにカートリッジ６２に形成されている１つ以上のステープル用孔部６４、６６、６８に代えて設けることであってもよい。特に図３および図５を参照すると、取り付けブロック７９、８１のような１つ以上の構造体をチャネル３０内に入れて、器械１０内での薬剤チューブ７８、８０（それぞれ）の固定および安定性を促進することができる。また、見れば分かるように、薬剤チューブ７８、８０は（左側の薬剤チューブ７８のように、例えば、図４に示されているように）、ナイフシャフト５６にほぼ隣接するように配置することができる。これは、薬剤チューブ７８、８０がシャフト２４を長さ方向に通って延びているからである。
さまざまな実施形態において、ハンドル部分２０は、１つ以上の医療用薬剤貯蔵容器９２、９４を有しいてもよく、この容器９２、９４は、ハンドル部分２０に取り付けられており、かつ、ケーシング７２とつながっている。貯蔵容器９２、９４には、さまざまな医療用薬剤または医療用薬剤の成分を入れることができ、これら医療用薬剤またはその成分は、手術用器械１０を使用するとともに投薬システムを作動させることにより、切断され、ステープル留めされた組織に有益に塗布されうる。開示の便宜上、複数の貯蔵容器９２、９４が器械１０とともに描かれているが、本発明のある実施形態は、貯蔵容器を１つだけ利用してもよいし、３つ以上の貯蔵容器を利用してもよい。見れば分かるように、複数の貯蔵容器９２、９４を利用すると、医療用薬剤投薬システムの動作中における多成分医療用薬剤のリアルタイムでの混合を容易にすることができる。例えば、一方の貯蔵容器９２には粉末を入れることができ、他方の貯蔵容器９４には液体を入れることができる。貯蔵容器９２、９４内の粉末および液体は、器械１０の動作中に、（例えば図３および図５に示されるように）Ｙ字状マニホールド９６を通して物質を送るなどして、混合されることができる。当然のことながら、医療用薬剤の成分を別個に貯蔵し、かつ、配置すると、有効期限を保つことができ、このため、個々の成分の有効性を保つことができる。別の例では、複数の貯蔵容器９２、９４を使用することにより、器械１０内の投薬システムの動作との関係で、例えば、２成分接着剤を使用することができる。
さらに、本発明の医療用薬剤投薬システムのさまざまな実施形態では、電動モータ９８をハンドル部分２０内に機械的なリンク機構とともに含めることができ、その機械的リンク機構は、モータ９８を起動すると、ポンプ用らせん状部のケーシング７２内のスクリューポンプ用らせん状部７６を回転駆動する構造となっている。当業者には分かるであろうが、電動モータ９８は、任意の従来のバッテリー駆動型またはＡＣ電源式のモータであって、手術用器械１０を動作させながらモータ９８を安全かつ効果的に利用するのに適した仕様（例えば、モータ定格）を備えたモータであってもよい。ある実施形態では、電動モータ９８が、従来の電気回路または電気部品１００を使って作動させられていてもよく、この電気回路または電機部品は、発射用引き金３８、リリースボタン４０、および／または、器械１０における独立していて、手動で動かすスイッチ１０２と機能的に結合されていてもよい。電気回路１００は、例えば器械１０の作動動作に対応して自動的にモータ９８を作動させるように構成されてもよく、および／または、スイッチ１０２を使用することによって、手動でモータ９８を作動させることであってもよく、スイッチ１０２は、器械１０を使用しているときに、例えば臨床医により押される。ある実施形態では、例えば、機械的に駆動されるロータリートリガーが、ケーシング７２と機能的に結合された機械式リンク機構と相互作用し、ケーシング７２内のスクリューポンプ用らせん状部７６を回転駆動するように構成されていてもよい。
図９を参照すると、プロセスのフローダイヤグラムが、医療用薬剤投薬システムを備えた器械１０を組織に行う外科手術において、本発明のさまざまな実施形態にしたがって利用する方法が示されている。ステップ２０２では、器械１０を前述したように作動し、組織を切断し、かつ、組織にできた切開部の両側の領域にステープルを施してもよい。ステップ２０４では、ナイフシャフト５６を切断され／ステープル留めされた組織から後退させるのに加えて、電動モータ９８を起動させ、ステップ２０６でのポンプ用らせん状部のケーシング７２の中にあるスクリューポンプ用らせん状部７６の回転を開始することができる。ステップ２０８では、（このステップは、実質的に、ステップ２０６と平行に行ってもよい）、ポンプ用らせん状部のケーシング７２に、多量の医療用薬剤、または、多量の医療用薬剤を造るために化合される成分がＹ字状マニホールド９６から入る。ステップ２１０では、医療用薬剤が、スクリューポンプ用らせん状部７６の回転動作により、横向きマニホールド７４まで送られる。ステップ２１２では、医療用薬剤が薬剤チューブ７８、８０に通され、ステップ２１４において、ステープル・カートリッジ６２にある複数の薬剤ポート８２、８４、８６を介して投薬されることであってもよい。いったん複数の薬剤ポート８２、８４、８６を介して投薬されると、医療用薬剤は、ステップ２０２において器械１０の動作により切断され、かつ、ステープル留めされた組織領域の少なくとも一部を覆う、または、浸すことができる。
当然のことながら、用語「近位」および「遠位」は、器械のハンドルを握っている臨床医を基準とするような、相対的な配置についての便利な用語として本明細書で用いることができる。例えば、エンド・エフェクター２６は、「近位」のハンドル部分２０に対して「遠位」であるとみなすことができる（図１参照）。これも当然のことであるが、開示の便宜と明確のため、相対的な配置に関する空間的な用語、例えば、「縦」および「横」、または、「下方」および「上方」は、本明細書では、図面に対して用いることができる。もっとも、当業者には分かるであろうが、手術用器械は、多くの向きおよび位置で使用することができ、このような用語は、限定したり、絶対的なものとしたりする意図はない。
本明細書に参照により組み込まれると述べたいずれの特許、刊行物、または、他の開示資料も、その全てまたは一部が、組み込まれた資料が、存在している定義、表現、または、本明細書に記載された他の開示資料と抵触しない限度に限り、参照により組み込まれる。このため、また、必要な範囲において、本明細書に明確に記載された開示内容は、参照により本明細書に組み込まれた、抵触するあらゆる資料に取って代わるものである。本明細書に参照により組み込まれると述べたあらゆる資料、または、その資料の一部であるが、存在している定義、表現、または、本明細書に記載されている他の開示資料は、組み込まれた資料と存在している開示資料との間で抵触が生じない範囲でのみ組み込まれる。
本明細書に記載された例は、当業者のために本発明の潜在的かつ具体的な実施形態を説明しようとしたものである。本明細書にある例のどの特定の１つまたは複数の実施態様も、必ずしも本発明の範囲を限定するものではない。
当然ながら、本発明の図面および記載は、本発明を明確に理解するのに適切である要素を説明する一方で、明確のために他の要素を削除するために簡単化されている。しかしながら、当業者には分かるであろうが、いろいろな要素が典型的なコンピュータシステムやデータベースシステムであることが好ましいかもしれない。しかし、このような要素は、当該技術で公知であるので、また、このような要素が本発明のよりよい理解を促進するのではないので、このような要素についての議論は、本明細書では行わない。
特定の機能を実行する手段として本明細書に示されたどの要素も、その機能を実行するあらゆる方法を網羅し、これには、例えば、その機能を実行する要素の組み合わせも含まれることが意図されている。さらに、本発明は、このようなミーンズ・プラス・ファンクション・クレームで定義された場合、列挙したさまざまな手段で提供される機能性が添付の特許請求の範囲で定義したような方法で組み合わされ、一緒にされるという事実にある。したがって、このような機能性を提供できるあらゆる手段が、本明細書で示された手段の均等物とみなされうる。
本明細書に開示された本発明のさまざまな実施形態において、所与の機能または所与の複数の機能を実行するために、１つの部品を複数の部品と置き換えてもよいし、複数の部品を１つの部品で置き換えてもよい。このような置換が、本発明の実施形態を実行する為に適切に作用しない場合を除き、このような置換は、本発明の範囲内である。
本発明は、いくつかの実施形態の記載により説明されているが、また、例示の実施形態が非常に詳細に記載されているが、出願人の意図は、添付されている特許請求の範囲をこのような詳細に制限する、すなわち、いかなる方法によっても限定しようとするものではない。さらに別の利点および変更を当業者は容易に思いつくであろう。本発明は、内視鏡下処置および装置に関して検討された。しかし、「内視鏡下の」のような用語の本明細書における使用は、本発明を内視鏡管（つまり、トロカール）とともにのみ使用する手術用ステープル留めおよび切断器械に限定するものと解釈すべきではない。むしろ、本発明にしたがった構造となっている手術用器械は、数多くの外科的処置に用途があろうし、これには限定はしないが、腹腔鏡処置および開腹処置が含まれている。さらに、唯一無二で新規な、本発明の実施形態は、他の形態のステープル留め装置とともに使用する場合は、本発明の趣旨および範囲から逸脱することのない有用性があるであろう。
〔実施態様〕
（１）組織を切断し、ステープル留めする構造となっている手術用切断／ステープル留め器械とともに使用する構造となっている医療用薬剤投薬システムにおいて、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器と、
前記貯蔵容器とつながっているギアポンプ用ケーシングと、
前記ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために、回転操作可能である、スクリューポンプ用らせん状部と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブであって、前記手術用切断／ステープル留め器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポート薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤用チューブと、
を備える、投薬システム。
（２）実施態様１記載の投薬システムにおいて、
前記医療用薬剤は、止血剤を含む、投薬システム。
（３）実施態様１記載の投薬システムにおいて、
前記医療用薬剤は、接着剤を含む、投薬システム。
（４）実施態様１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、前記手術用切断／ステープル留め器械のスパイン(spine)を通って長さ方向に延びるように配置されている、投薬システム。
（５）実施態様１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、横向きマニホールドを介して前記薬剤チューブとつながっている、投薬システム。
（６）実施態様５記載の投薬システムにおいて、
前記薬剤チューブは、前記横向きマニホールド、および複数の前記薬剤ポートの両方とつながっている、投薬システム。
（７）実施態様１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の薬剤チューブ、
をさらに備え、
前記第１の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第１の薬剤ポートとつながっており、
前記第２の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第２の薬剤ポートとつながっている、
投薬システム。
（８）実施態様１記載の投薬システムにおいて、
前記ステープル・カートリッジの少なくとも１つのステープル用孔部にほぼ隣接するように形成されている、少なくとも１つの薬剤ポート、
をさらに備えている、投薬システム。
（９）実施態様１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の貯蔵容器、
をさらに備えており、
前記第２の貯蔵容器が、少なくとも前記医療用薬剤の成分を貯蔵する構造となっている、
投薬システム。
（１０）実施態様９記載の投薬システムにおいて、
前記第１の貯蔵容器に貯蔵されている前記成分と、前記第２の貯蔵容器にある前記成分とは、化合させると前記医療用薬剤を形成するように設計されている、投薬システム。
（１１）実施態様９記載の投薬システムにおいて、
前記第１の貯蔵容器および前記第２の貯蔵容器の両方とつながっているＹ字状マニホールド、
をさらに備えている、投薬システム。
（１２）実施態様１記載の投薬システムにおいて、
電動モータ、
をさらに備え、
前記電動モータが、前記ポンプ用らせん状のケーシング内にある前記スクリューポンプ用らせん状部を回転駆動する構造となっている、
投薬システム。
（１３）実施態様１記載の投薬システムにおいて、
機械的に動かされるロータリー式引き金、
をさらに備え、
前記ロータリー式引き金が、前記ポンプ用らせん状部のケーシング内の前記スクリューポンプ用らせん状部を回転駆動するように構成されている、
投薬システム。
（１４）医療用薬剤投薬システムを含む手術用切断／ステープル留め器械において、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器を含むハンドル部分と、
前記ハンドル部分に連結されているシャフト部分であって、前記シャフト部分が、前記貯蔵容器とつながっているギアポンプ用ケーシングを含み、前記ギアポンプ用ケーシングがスクリューポンプ用らせん状部を含み、前記スクリューポンプ用らせん状部は、前記ギアポンプ用ケーシングを通って延びており、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために回転操作可能である、シャフト部分と、
前記シャフト部分に機能的に結合されているエンド・エフェクター部分であって、チャネルを有し、ステープル・カートリッジが前記チャネルに取り外し可能に配置されている、エンド・エフェクター部分と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤チューブであって、前記シャフト部分から延びていて、前記ステープル・カートリッジに形成された少なくとも１つの薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤チューブと、
を備えている、器械。
（１５）実施態様１４記載の器械において、
前記医療用薬剤は、止血剤を含む、器械。
（１６）実施態様１４記載の器械において、
前記医療用薬剤は、接着剤を含む、器械。
（１７）実施態様１４記載の器械において、
前記ポンプ用らせん状部のケーシングは、横向きマニホールドを介して前記薬剤用チューブとつながっている、器械。
（１８）実施態様１４記載の器械において、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の薬剤チューブ、
をさらに備え、
前記第１の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第１の薬剤ポートとつながっており、
前記第２の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第２の薬剤ポートとつながっている、
器械。
（１９）実施態様１４記載の器械において、
少なくとも第２の貯蔵容器を含むハンドル部分、
をさらに備え、
前記第２の貯蔵容器が、前記ギアポンプ用ケーシングとつながっており、かつ少なくとも前記医療用薬剤の成分を貯蔵する構造となっている、
器械。
（２０）実施態様１９記載の器械において、
前記第１の貯蔵容器に貯蔵されている前記成分と、前記第２の貯蔵容器にある前記成分とは、化合させると前記医療用薬剤を形成するように設計されている、器械。
（１）組織を切断し、ステープル留めする構造となっている手術用切断／ステープル留め器械とともに使用する構造となっている医療用薬剤投薬システムにおいて、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器と、
前記貯蔵容器とつながっているギアポンプ用ケーシングと、
前記ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために、回転操作可能である、スクリューポンプ用らせん状部と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブであって、前記手術用切断／ステープル留め器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポート薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤用チューブと、
を備える、投薬システム。
（２）実施態様１記載の投薬システムにおいて、
前記医療用薬剤は、止血剤を含む、投薬システム。
（３）実施態様１記載の投薬システムにおいて、
前記医療用薬剤は、接着剤を含む、投薬システム。
（４）実施態様１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、前記手術用切断／ステープル留め器械のスパイン(spine)を通って長さ方向に延びるように配置されている、投薬システム。
（５）実施態様１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、横向きマニホールドを介して前記薬剤チューブとつながっている、投薬システム。
（６）実施態様５記載の投薬システムにおいて、
前記薬剤チューブは、前記横向きマニホールド、および複数の前記薬剤ポートの両方とつながっている、投薬システム。
（７）実施態様１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の薬剤チューブ、
をさらに備え、
前記第１の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第１の薬剤ポートとつながっており、
前記第２の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第２の薬剤ポートとつながっている、
投薬システム。
（８）実施態様１記載の投薬システムにおいて、
前記ステープル・カートリッジの少なくとも１つのステープル用孔部にほぼ隣接するように形成されている、少なくとも１つの薬剤ポート、
をさらに備えている、投薬システム。
（９）実施態様１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の貯蔵容器、
をさらに備えており、
前記第２の貯蔵容器が、少なくとも前記医療用薬剤の成分を貯蔵する構造となっている、
投薬システム。
（１０）実施態様９記載の投薬システムにおいて、
前記第１の貯蔵容器に貯蔵されている前記成分と、前記第２の貯蔵容器にある前記成分とは、化合させると前記医療用薬剤を形成するように設計されている、投薬システム。
（１１）実施態様９記載の投薬システムにおいて、
前記第１の貯蔵容器および前記第２の貯蔵容器の両方とつながっているＹ字状マニホールド、
をさらに備えている、投薬システム。
（１２）実施態様１記載の投薬システムにおいて、
電動モータ、
をさらに備え、
前記電動モータが、前記ポンプ用らせん状のケーシング内にある前記スクリューポンプ用らせん状部を回転駆動する構造となっている、
投薬システム。
（１３）実施態様１記載の投薬システムにおいて、
機械的に動かされるロータリー式引き金、
をさらに備え、
前記ロータリー式引き金が、前記ポンプ用らせん状部のケーシング内の前記スクリューポンプ用らせん状部を回転駆動するように構成されている、
投薬システム。
（１４）医療用薬剤投薬システムを含む手術用切断／ステープル留め器械において、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器を含むハンドル部分と、
前記ハンドル部分に連結されているシャフト部分であって、前記シャフト部分が、前記貯蔵容器とつながっているギアポンプ用ケーシングを含み、前記ギアポンプ用ケーシングがスクリューポンプ用らせん状部を含み、前記スクリューポンプ用らせん状部は、前記ギアポンプ用ケーシングを通って延びており、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために回転操作可能である、シャフト部分と、
前記シャフト部分に機能的に結合されているエンド・エフェクター部分であって、チャネルを有し、ステープル・カートリッジが前記チャネルに取り外し可能に配置されている、エンド・エフェクター部分と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤チューブであって、前記シャフト部分から延びていて、前記ステープル・カートリッジに形成された少なくとも１つの薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤チューブと、
を備えている、器械。
（１５）実施態様１４記載の器械において、
前記医療用薬剤は、止血剤を含む、器械。
（１６）実施態様１４記載の器械において、
前記医療用薬剤は、接着剤を含む、器械。
（１７）実施態様１４記載の器械において、
前記ポンプ用らせん状部のケーシングは、横向きマニホールドを介して前記薬剤用チューブとつながっている、器械。
（１８）実施態様１４記載の器械において、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の薬剤チューブ、
をさらに備え、
前記第１の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第１の薬剤ポートとつながっており、
前記第２の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第２の薬剤ポートとつながっている、
器械。
（１９）実施態様１４記載の器械において、
少なくとも第２の貯蔵容器を含むハンドル部分、
をさらに備え、
前記第２の貯蔵容器が、前記ギアポンプ用ケーシングとつながっており、かつ少なくとも前記医療用薬剤の成分を貯蔵する構造となっている、
器械。
（２０）実施態様１９記載の器械において、
前記第１の貯蔵容器に貯蔵されている前記成分と、前記第２の貯蔵容器にある前記成分とは、化合させると前記医療用薬剤を形成するように設計されている、器械。
Claims (11)
- 組織を切断し、ステープル留めする構造となっている手術用切断／ステープル留め器械とともに使用する構造となっている医療用薬剤投薬システムにおいて、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器と、
前記貯蔵容器とつながっているギアポンプ用ケーシングと、
前記ギアポンプ用ケーシング内に配置されているスクリューポンプ用らせん状部であって、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために回転操作可能である、スクリューポンプ用らせん状部と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤用チューブであって、前記手術用切断／ステープル留め器械のステープル・カートリッジに形成されている少なくとも１つの薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤用チューブと、
を備える、投薬システム。 - 請求項１記載の投薬システムにおいて、
前記医療用薬剤は、止血剤を含む、投薬システム。 - 請求項１記載の投薬システムにおいて、
前記医療用薬剤は、接着剤を含む、投薬システム。 - 請求項１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、前記手術用切断／ステープル留め器械のスパイン(spine)を通って長さ方向に延びるように配置されている、投薬システム。 - 請求項１記載の投薬システムにおいて、
前記ポンプ用らせん状部のケーシングは、横向きマニホールドを介して前記薬剤チューブとつながっている、投薬システム。 - 請求項５記載の投薬システムにおいて、
前記薬剤チューブは、前記横向きマニホールド、および複数の前記薬剤ポートの両方とつながっている、投薬システム。 - 請求項１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の薬剤チューブ、
をさらに備え、
前記第１の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第１の薬剤ポートとつながっており、
前記第２の薬剤チューブは、前記ステープル・カートリッジに形成されている複数の第２の薬剤ポートとつながっている、
投薬システム。 - 請求項１記載の投薬システムにおいて、
前記ステープル・カートリッジの少なくとも１つのステープル用孔部にほぼ隣接するように形成されている、少なくとも１つの薬剤ポート、
をさらに備えている、投薬システム。 - 請求項１記載の投薬システムにおいて、
少なくとも、前記ギアポンプ用ケーシングとつながっている第２の貯蔵容器、
をさらに備えており、
前記第２の貯蔵容器が、少なくとも前記医療用薬剤の成分を貯蔵する構造となっている、
投薬システム。 - 請求項９記載の投薬システムにおいて、
前記第１の貯蔵容器に貯蔵されている前記成分と、前記第２の貯蔵容器にある前記成分とは、化合させると前記医療用薬剤を形成するように設計されている、投薬システム。 - 医療用薬剤投薬システムを含む手術用切断／ステープル留め器械において、
少なくとも医療用薬剤の成分を貯蔵する構造となっている少なくとも１つの貯蔵容器を含むハンドル部分と、
前記ハンドル部分に連結されているシャフト部分であって、前記シャフト部分が、前記貯蔵容器とつながっているギアポンプ用ケーシングを含み、前記ギアポンプ用ケーシングが、スクリューポンプ用らせん状部を含み、前記スクリューポンプ用らせん状部は、前記ギアポンプ用ケーシングを通って延びており、前記ギアポンプ用ケーシングを介して前記医療用薬剤を移動させるために回転操作可能である、シャフト部分と、
前記シャフト部分に機能的に結合されているエンド・エフェクター部分であって、チャネルを有し、ステープル・カートリッジが前記チャネルに取り外し可能に配置されている、エンド・エフェクター部分と、
前記ギアポンプ用ケーシングとつながっている少なくとも１つの薬剤チューブであって、前記シャフト部分から延びていて、前記ステープル・カートリッジに形成された少なくとも１つの薬剤ポートを介して前記医療用薬剤を投薬するために、前記薬剤ポートとつながっている、薬剤チューブと、
を備えている、器械。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US11/267,811 | 2005-11-04 | ||
| US11/267,811 US7673783B2 (en) | 2005-11-04 | 2005-11-04 | Surgical stapling instruments structured for delivery of medical agents |
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| JP2007125397A true JP2007125397A (ja) | 2007-05-24 |
| JP5265104B2 JP5265104B2 (ja) | 2013-08-14 |
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| US (2) | US7673783B2 (ja) |
| EP (1) | EP1782740B1 (ja) |
| JP (1) | JP5265104B2 (ja) |
| CN (1) | CN1957853B (ja) |
| AT (1) | ATE400222T1 (ja) |
| AU (1) | AU2006230751B8 (ja) |
| BR (1) | BRPI0604531B8 (ja) |
| CA (1) | CA2566911C (ja) |
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| US7905380B2 (en) | 2007-06-04 | 2011-03-15 | Ethicon Endo-Surgery, Inc. | Surgical instrument having a multiple rate directional switching mechanism |
| US20080308602A1 (en) | 2007-06-18 | 2008-12-18 | Timm Richard W | Surgical stapling and cutting instruments |
| US7597229B2 (en) | 2007-06-22 | 2009-10-06 | Ethicon Endo-Surgery, Inc. | End effector closure system for a surgical stapling instrument |
| US7753245B2 (en) | 2007-06-22 | 2010-07-13 | Ethicon Endo-Surgery, Inc. | Surgical stapling instruments |
| US7441685B1 (en) | 2007-06-22 | 2008-10-28 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a return mechanism |
| US7604150B2 (en) | 2007-06-22 | 2009-10-20 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with an anti-back up mechanism |
| US7658311B2 (en) | 2007-06-22 | 2010-02-09 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument with a geared return mechanism |
-
2005
- 2005-11-04 US US11/267,811 patent/US7673783B2/en active Active
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2006
- 2006-10-20 AU AU2006230751A patent/AU2006230751B8/en not_active Ceased
- 2006-11-02 JP JP2006299362A patent/JP5265104B2/ja active Active
- 2006-11-02 CA CA2566911A patent/CA2566911C/en not_active Expired - Fee Related
- 2006-11-03 AT AT06255682T patent/ATE400222T1/de not_active IP Right Cessation
- 2006-11-03 CN CN200610143750XA patent/CN1957853B/zh not_active Expired - Fee Related
- 2006-11-03 DE DE602006001718T patent/DE602006001718D1/de active Active
- 2006-11-03 EP EP06255682A patent/EP1782740B1/en not_active Not-in-force
- 2006-11-03 MX MXPA06012766A patent/MXPA06012766A/es active IP Right Grant
- 2006-11-06 BR BRPI0604531A patent/BRPI0604531B8/pt not_active IP Right Cessation
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2010
- 2010-02-01 US US12/697,332 patent/US20100127041A1/en not_active Abandoned
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| Publication number | Priority date | Publication date | Assignee | Title |
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| JPH0357457A (ja) * | 1989-07-26 | 1991-03-12 | Olympus Optical Co Ltd | 体内埋込型ポンプ |
| JPH06327685A (ja) * | 1993-05-19 | 1994-11-29 | Olympus Optical Co Ltd | 外科用器具 |
| WO2003094746A1 (en) * | 2002-05-10 | 2003-11-20 | Tyco Healthcare Group, Lp | Surgical stapling apparatus having a wound closure material applicator assembly |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPWO2011089718A1 (ja) * | 2010-01-22 | 2013-05-20 | オリンパスメディカルシステムズ株式会社 | 治療用処置具、治療用処置装置および治療処置方法 |
| JP5231658B2 (ja) * | 2010-01-22 | 2013-07-10 | オリンパスメディカルシステムズ株式会社 | 治療用処置装置および治療用処置装置の制御方法 |
| JP5231659B2 (ja) * | 2010-01-22 | 2013-07-10 | オリンパスメディカルシステムズ株式会社 | 治療用処置装置 |
| US9039705B2 (en) | 2010-01-22 | 2015-05-26 | Olympus Medical Systems Corp. | Medical treatment apparatus and control method of medical treatment device |
| KR20200018033A (ko) * | 2018-08-10 | 2020-02-19 | (주)지 메디 | 지혈성능을 향상시킨 외과용 봉합기 |
| KR102109964B1 (ko) | 2018-08-10 | 2020-05-12 | (주)지 메디 | 지혈성능을 향상시킨 외과용 봉합기 |
Also Published As
| Publication number | Publication date |
|---|---|
| AU2006230751B8 (en) | 2013-01-31 |
| ATE400222T1 (de) | 2008-07-15 |
| BRPI0604531B1 (pt) | 2018-02-06 |
| CN1957853B (zh) | 2011-07-20 |
| BRPI0604531B8 (pt) | 2021-06-22 |
| MXPA06012766A (es) | 2007-05-03 |
| BRPI0604531A (pt) | 2007-08-28 |
| CN1957853A (zh) | 2007-05-09 |
| DE602006001718D1 (de) | 2008-08-21 |
| EP1782740B1 (en) | 2008-07-09 |
| AU2006230751A1 (en) | 2007-05-24 |
| CA2566911A1 (en) | 2007-05-04 |
| US20070102453A1 (en) | 2007-05-10 |
| AU2006230751B2 (en) | 2012-10-04 |
| US7673783B2 (en) | 2010-03-09 |
| US20100127041A1 (en) | 2010-05-27 |
| EP1782740A1 (en) | 2007-05-09 |
| JP5265104B2 (ja) | 2013-08-14 |
| CA2566911C (en) | 2015-01-20 |
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