JP2007144169A - 手術用クリップおよびアプライヤー装置および使用方法 - Google Patents
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Abstract
【解決手段】脈管、他の管状導管等のような組織を結紮、切断するための手術用クリップ10、および、その手術用クリップ10を組織まで送達し、取り付けるための手術用クリップアプライヤー装置が提供された。手術用クリップ10は、背骨部12と、その背骨部12から延在する対向するアーム14,16を含むことができ、アーム14,16は、クランプ締め長さを画定できる。休止状態では、クリップ10は、対向するアーム14,16のそれぞれが互いの近傍に配置された、閉じた位置に付勢されることができる。このように付勢した状態では、手術用クリップアプライヤーなどを用いて組織に取り付けられると、クリップ10は、クランプ締め長さに沿って組織に確実にクランプ締め圧力を加え、組織を密閉し、血液のような流体が組織を通ることを制限できる。
【選択図】図1A
Description
本発明は、概して、手術装置に関し、より詳細には、手術用クリップ、手術用クリップアプライヤー、および、静脈、他の導管等を結紮するための使用方法に関する。
近年、手術は、腹腔鏡下でのおよび内視鏡下での外科手術の性能によって著しく進歩した。内視鏡手技は、天然の開口部を介して行われ、一方、腹腔鏡外科手術は、多くの場合、トロカール組立体(trocar assembly)のようなアクセスポート(access port)を通して行われる。トロカールは典型的に、体腔に穴をあけるのに用いられる手術器具である。トロカールは、通常、鋭利にしたオブチュレータ先端部(obturator tip)と、トロカールチューブ、すなわち、カニューレと、を含む。トロカールのカニューレは、皮膚に挿入されて、体腔に入る。これは、皮膚を刺し通すのにオブチュレータ先端部を使って行われる。貫通した後、オブチュレータ先端部は取り去られ、トロカールのカニューレが体内に残る。
本発明の実施形態は、概して、手術用クリップ、クリップアプライヤー装置、および、組織を結紮および切断する方法を提供する。
次に、本明細書に開示された装置および方法の原理、構造、機能、製造、および、用途を全般的に理解するために、特定の例示的な実施形態を説明する。これらの実施形態の1つ以上の例が添付の図面に図示されている。当業者には、本明細書に具体的に記載され、かつ、添付図面に図示された装置および方法が非限定的で例示的な実施形態であること、および、本発明の範囲が特許請求の範囲によってのみ画定されることは分かるであろう。1つの例示的な実施形態との関係で図示し、または、記載した特徴は、他の実施形態の特徴と組み合わせられることであってもよい。このような変更例および変形例は、本発明の範囲内に含まれることが意図されている。
(1)手術用クリップにおいて、
上部端部および下部端部によって画定された高さを有し、第1クリップ端部から第2クリップ端部まで縦方向軸に沿って延在している、背骨部と、
前記背骨部の上部端部および下部端部から延びている対向するアームであって、前記向き合ったアームの各々の端部が互いの近傍に配置されて、前記アームによって規定されたクランプ締め長さを有する組織クランプ締め領域を規定するように、閉じた位置に付勢されている対向するアームと、を備える手術用クリップ。
(2)実施態様1記載の手術用クリップにおいて、
前記手術用クリップが、前記組織クランプ締め領域の長さを選択的に調整できるように、前記長さに沿った1つ以上の場所において折れやすくなっている、手術用クリップ。
(3)実施態様1記載の手術用クリップにおいて、
前記クリップの前記背骨部は、前記クリップの形状を選択的に変えられるように、縦方向に沿って曲げられる、手術用クリップ。
(4)実施態様1記載の手術用クリップにおいて、
前記対向するアームのそれぞれは、前記クリップの長さに沿って配置された1つ以上の細長い溝部を含み、
前記細長い溝部のそれぞれは、前記対向するアームのそれぞれの端部から前記背骨部に向かって、前記クリップの縦方向軸を実質的に横切る方向に延在している、
手術用クリップ。
(5)実施態様4記載の手術用クリップにおいて、
前記細長い溝部のそれぞれが、前記背骨部の近傍の位置において終端している、手術用クリップ。
前記対向するアームの端部が、前記クリップを組織に固定するように構成された組織保持要素を備えている、手術用クリップ。
(7)実施態様6記載の手術用クリップにおいて、
第1のアームの組織保持要素が、対向する第2のアームの組織保持要素に対して、長さに沿って互い違いになっている、手術用クリップ。
(8)実施態様1記載の手術用クリップにおいて、
切開要素(incising element)が、前記第1クリップ端部および前記第2クリップ端部の一方に一体に形成されている、手術用クリップ。
(9)実施態様1記載の手術用クリップにおいて、
前記組織クランプ締め領域の長さが、前記背骨部の長さより長い、手術用クリップ。
(10)実施態様1記載の手術用クリップにおいて、
前記対向するアームのそれぞれが、前記背骨部に対して鋭角に配置されている、手術用クリップ。
前記クリップが、バネ特性を有する材料から形成されており、前記材料が、金属、金属合金、および、ポリマーからなる群から選択されている、手術用クリップ。
(12)実施態様11記載の手術用クリップにおいて、
前記材料は、ニチノール、ステンレス鋼、および、バネ鋼からなる群から選択されている、手術用クリップ。
(13)実施態様11記載の手術用クリップにおいて、
前記クリップが、生体吸収性ポリマーから形成されている、手術用クリップ。
(14)実施態様13記載の手術用クリップにおいて、
前記生体吸収性ポリマーが、ポリグリコリド、ポリジオキサノン、および、ポリラクチドからなる群から選択されている、手術用クリップ。
(15)実施態様1記載の手術用クリップにおいて、
前記対向するアームの端部が、前記閉じた位置において互いに接触する、手術用クリップ。
前記対向するアームの端部が、前記閉じた位置において互いに離間して配置されている、手術用クリップ。
(17)手術用ファスナー送達システムにおいて、
ハンドル、および前記ハンドルから延びる細長いシャフト、を有する送達装置であって、前記細長いシャフトが、対向する顎部を有し、前記対向する顎部が、前記細長いシャフトの遠位端に配置されており、開いて離間した位置と閉じた位置との間で動くように操作可能である、送達装置と、
前記送達装置の中に配置されるように構成された手術用クリップ供給源であって、少なくとも1つの手術用クリップを含み、前記少なくとも1つの手術用クリップは、背骨部、および前記背骨部から延びる対向するアームを有し、前記アームの各々の端部が、互いの近傍に配置されて、クランプ締め領域を規定するように、前記アームは閉じた位置に付勢されている、手術用クリップ供給源と、
クリップオープニング機構であって、前記クリップオープニング機構は、前記送達装置の中に配置されており、かつ、前記閉じた位置から、前記対向するアームのそれぞれの端部が離間した位置に配置されて組織収容空間を画定する、開いた送達する位置へと、前記少なくとも1つの手術用クリップを位置させるように操作可能である、クリップオープニング機構と、
を備える、手術用ファスナー送達システム。
(18)実施態様17記載のシステムにおいて、
前記送達装置の中に配置された切断要素(cutting element)であって、前記切断要素が、前記細長いシャフトの遠位端に対して後退した位置から伸長した位置まで選択的に可動であり、前記対向する顎部の間に配置された組織を切開するのに用いることができる、切断要素、
をさらに備える、システム。
(19)実施態様17記載のシステムにおいて、
前記開いて離間した位置と前記閉じた位置との間に前記対向する顎部を位置させるように形成された、顎部閉鎖組立体、
を備える、システム。
(20)実施態様17記載のシステムにおいて、
クリップ前進組立体であって、前記手術用クリップ供給源の前記少なくとも1つの手術用クリップを前記細長いシャフトから前記対向する顎部の間の位置まで動かすように形成されている、クリップ前進組立体、
を備える、システム。
前記クリップ前進組立体が、少なくとも1つの押圧棒と、前進用ラチェットとを備え、
前記前進用ラチェットが、前記少なくとも1つの手術用クリップを前記対向する顎部に向けて前進させるように形成されている、
システム。
(22)実施態様17記載のシステムにおいて、
前記クリップオープニング機構が、前記細長いシャフトの中に配置された傾斜面要素(ramp element)を備える、システム。
(23)実施態様17記載のシステムにおいて、
前記クリップオープニング機構が、前記細長いシャフトに可動に連結されており、前記少なくとも1つの手術用クリップが前記対向する顎部の方へ動かされたときに、前記細長いシャフトの縦方向軸に沿って移動して、前記少なくとも1つの手術用クリップのアームを開いた送達する位置に維持するように操作可能である、システム。
(24)実施態様17記載のシステムにおいて、
前記対向する顎部が、前記細長いシャフトの縦方向軸に対して湾曲している、システム。
(25)手術用クリップを取り付ける方法において、
対向するアームを有する手術用クリップを提供する過程であって、前記対向するアームのそれぞれの端部が互いの近傍に配置されている、閉じた位置に、前記対向するアームが付勢されている、過程と、
前記手術用クリップの付勢の力に打ち勝って、前記対向するアームを開いた位置に引き離す過程と、
前記手術用クリップを、結紮し、切断しようとする組織に取り付ける過程と、
前記クリップで前記組織を密閉するように閉じる過程と、
を含む、方法。
前記手術用クリップを前記組織に取り付ける前に、密閉しようとする前記組織にクランプ締めのための力を加える過程、
を含む、方法。
(27)実施態様26記載の方法において、
前記手術用クリップを前記組織に取り付ける前に、前記クランプ締めされた組織を切開する過程、
を含む、方法。
Claims (11)
- 手術用クリップにおいて、
上部端部および下部端部によって画定された高さを有し、第1クリップ端部から第2クリップ端部まで縦方向軸に沿って延在している、背骨部と、
前記背骨部の上部端部および下部端部から延びている対向するアームであって、前記向き合ったアームの各々の端部が互いの近傍に配置されて、前記アームによって規定されたクランプ締め長さを有する組織クランプ締め領域を規定するように、閉じた位置に付勢されている対向するアームと、を備える手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記手術用クリップが、前記組織クランプ締め領域の長さを選択的に調整できるように、前記長さに沿った1つ以上の場所において折れやすくなっている、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記クリップの前記背骨部は、前記クリップの形状を選択的に変えられるように、縦方向に沿って曲げられる、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記対向するアームのそれぞれは、前記クリップの長さに沿って配置された1つ以上の細長い溝部を含み、
前記細長い溝部のそれぞれは、前記対向するアームのそれぞれの端部から前記背骨部に向かって、前記クリップの縦方向軸を実質的に横切る方向に延在している、
手術用クリップ。 - 請求項4記載の手術用クリップにおいて、
前記細長い溝部のそれぞれが、前記背骨部の近傍の位置において終端している、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記対向するアームの端部が、前記クリップを組織に固定するように構成された組織保持要素を備えている、手術用クリップ。 - 請求項6記載の手術用クリップにおいて、
第1のアームの組織保持要素が、対向する第2のアームの組織保持要素に対して、長さに沿って互い違いになっている、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
切開要素(incising element)が、前記第1クリップ端部および前記第2クリップ端部の一方に一体に形成されている、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記組織クランプ締め領域の長さが、前記背骨部の長さより長い、手術用クリップ。 - 請求項1記載の手術用クリップにおいて、
前記対向するアームのそれぞれが、前記背骨部に対して鋭角に配置されている、手術用クリップ。 - 手術用ファスナー送達システムにおいて、
ハンドル、および前記ハンドルから延びる細長いシャフト、を有する送達装置であって、前記細長いシャフトが、対向する顎部を有し、前記対向する顎部が、前記細長いシャフトの遠位端に配置されており、開いて離間した位置と閉じた位置との間で動くように操作可能である、送達装置と、
前記送達装置の中に配置されるように構成された手術用クリップ供給源であって、少なくとも1つの手術用クリップを含み、前記少なくとも1つの手術用クリップは、背骨部、および前記背骨部から延びる対向するアームを有し、前記アームの各々の端部が、互いの近傍に配置されて、クランプ締め領域を規定するように、前記アームは閉じた位置に付勢されている、手術用クリップ供給源と、
クリップオープニング機構であって、前記クリップオープニング機構は、前記送達装置の中に配置されており、かつ、前記閉じた位置から、前記対向するアームのそれぞれの端部が離間した位置に配置されて組織収容空間を画定する、開いた送達する位置へと、前記少なくとも1つの手術用クリップを位置させるように操作可能である、クリップオープニング機構と、
を備える、手術用ファスナー送達システム。
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AT (1) | ATE476922T1 (ja) |
AU (1) | AU2006236074B2 (ja) |
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CA2568577A1 (en) | 2007-05-23 |
EP1813214B1 (en) | 2010-08-11 |
BRPI0604930A (pt) | 2007-09-04 |
AU2006236074B2 (en) | 2012-12-13 |
US8915931B2 (en) | 2014-12-23 |
US10105144B2 (en) | 2018-10-23 |
CN1969769A (zh) | 2007-05-30 |
US20150080915A1 (en) | 2015-03-19 |
US20070118163A1 (en) | 2007-05-24 |
EP1813214A1 (en) | 2007-08-01 |
US7896895B2 (en) | 2011-03-01 |
BRPI0604930B1 (pt) | 2018-02-14 |
CA2568577C (en) | 2016-01-05 |
DE602006016060D1 (de) | 2010-09-23 |
JP5073274B2 (ja) | 2012-11-14 |
HK1106117A1 (en) | 2008-03-07 |
MXPA06013576A (es) | 2008-10-15 |
ATE476922T1 (de) | 2010-08-15 |
AU2006236074A1 (en) | 2007-06-07 |
US20110137324A1 (en) | 2011-06-09 |
BRPI0604930B8 (pt) | 2021-06-22 |
CN1969769B (zh) | 2010-11-17 |
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