JP2008093434A - 関節運動ツールアセンブリを備えた外科用器具 - Google Patents

関節運動ツールアセンブリを備えた外科用器具 Download PDF

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JP2008093434A
JP2008093434A JP2007260421A JP2007260421A JP2008093434A JP 2008093434 A JP2008093434 A JP 2008093434A JP 2007260421 A JP2007260421 A JP 2007260421A JP 2007260421 A JP2007260421 A JP 2007260421A JP 2008093434 A JP2008093434 A JP 2008093434A
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tool assembly
assembly
surgical instrument
coupling member
body portion
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Paul Scirica
シリカ ポール
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Covidien LP
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Tyco Healthcare Group LP
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Abstract

【課題】ツールアセンブリが関節運動することが所望されるまで、このツールアセンブリを非関節運動位置に離脱可能に固定できる外科用器具を提供すること。
【解決手段】少なくとも１つのスプリングアーム２４６ｃを有し、本体部分の一部分に固定可能である少なくとも１つのカップリング部材２４６であって、スプリングアーム２４６ｃの少なくとも一部分が関節運動ツールアセンブリ１７の窪み２３６ｂ中に受容可能であり、関節運動ツールアセンブリ１７を第１の位置に、少なくとも１つのスプリングアーム２４６ｃを外方に曲げるに十分な所定の力がツールアセンブリ１７に付与され、ツールアセンブリ１７を関節運動させるまで離脱可能に保持する少なくとも１つのカップリング部材２４６を備える外科用器具である。
【選択図】図１

Description

（技術分野）
本開示は、関節運動ツールアセンブリを有する外科用器具に関する。より特定すれば、本開示は、関節運動する外科用器具のツールアセンブリ、例えば、直線状ステープラが、このツールアセンブリの関節運動が所望されるまで非関節運動位置に保持するための機構を含む外科用器具に関する。
（背景）
関節運動のための外科用器具の本体部分の遠位端上に取り付けられたツールアセンブリを含む外科用器具は周知である。代表的には、このような外科用器具は、操作者が外科用器具の本体部分に対して上記ツールアセンブリを遠隔から関節運動することを可能にし、操作者が組織により容易に接近し、手術し、そして／または操作することを可能にする関節運動制御機構を含む。
このような関節運動ツールアセンブリは、特に内視鏡外科的手順で所望されるようになった。内視鏡外科的手順では、外科用器具の遠位端は、身体中の小切開を通って挿入され、手術部位に接近する。代表的には、適切なサイズ、例えば、５ｍｍ、１０ｍｍなどのカニューレが、この身体切開を通って挿入され、手術部位に接近するための案内チャネルを提供する。小さな身体切開、すなわち、患者に対するより小さな瘢痕の低減された外傷、より迅速な治癒時間を提供することが所望されるので、外科用器具とカニューレの内径との間の許容誤差は小さい。
関節運動ツールアセンブリを有する外科用器具が内視鏡手順の間に用いられるとき、この関節運動ツールアセンブリは、カニューレまたは小さな身体切開を通るこのツールアセンブリの挿入の間に、一般に、その非関節運動位置（すなわち、このツールアセンブリの長手方向軸が外科用器具の本体部分の長手方向軸と整列される位置）にある。このツールアセンブリの関節運動された位置への移動は、外科用器具の本体部分とのわずかな誤整列でさえ、カニューレまたは小さな身体切開を通るこの外科用器具の遠位端の挿入を妨害、そして／または防ぎ得る。
関節運動するツールアセンブリを有する外科用器具の操作または取り扱いの間に、このツールアセンブリが、その非関節運動位置から関節運動位置まで移動するように食い違うか、または揺れることは一般的でない。上記で論議されたように、これは、特にこの外科用器具が内視鏡手術手順で用いられるとき、所望されない。さらに、このツールアセンブリがハンドル部分に対してその位置を保持する能力は、このツールアセンブリを用いて外科医が如何に良好に組織を操作し得るに影響する。
従って、ツールアセンブリが関節運動することが所望されるまで、このツールアセンブリを非関節運動位置に離脱可能に固定するための保持具部材を備えた関節運動するツールアセンブリを有する外科用器具を提供することが所望され得る。
本発明は例えば以下の手段を提供する。
（項目１）
ハンドル部分と、
該ハンドル部分から遠位側に延び、第１の長手方向軸を定義する本体部分と、
第２の長手方向軸を定義し、その中に少なくとも１つの窪みを含む関節運動ツールアセンブリであって、該本体部分の遠位端に配置され、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から、少なくとも該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動させるまで離脱可能に保持する少なくとも１つのカップリング部材とを備える、外科用器具。
（項目２）
前記関節運動ツールアセンブリの近位端が、取り付けアセンブリを含む、項目１に記載の外科用器具。
（項目３）
前記窪みが、前記取り付けアセンブリの一部分中に形成される、項目２に記載の外科用器具。
（項目４）
前記取り付けアセンブリの一部分が、前記本体部分の遠位端に旋回可能に固定され、前記関節運動ツールアセンブリの一部分に固定して取り付けられる、項目２に記載の外科用器具。
（項目５）
前記第１の長手方向軸に垂直な軸の周りの前記取り付けアセンブリの一部分の旋回移動が、前記関節運動ツールアセンブリを前記第１の位置と前記第２の位置との間で移動させる、項目２に記載の外科用器具。
（項目６）
前記カップリング部材の一部分が前記本体部分の一部分に固定可能であり、そして該カップリング部材の少なくとも一部分が、前記取り付けアセンブリの少なくとも一部分に旋回可能に固定可能である、項目２に記載の外科用器具。
（項目７）
前記取り付けアセンブリが、上部取り付け部分および下部取り付け部分を含む、項目２に記載の外科用器具。
（項目８）
前記少なくと１つのカップリング部材が第１のカップリング部材および第２のカップリング部材を含み、各カップリング部材が前記関節運動ツールアセンブリの少なくとも一部分および前記本体部分の少なくとも一部分との機械的協動に配置される、項目１に記載の外科用器具。
（項目９）
前記関節運動ツールアセンブリの近位端上に支持される取り付けアセンブリをさらに含み、該取り付けアセンブリが上部取り付け部分および下部取り付け部分を含み、前記第１のカップリング部材が該上部取り付け部分の少なくとも一部分との機械的協動に配置され、前記第２のカップリング部材が該下部取り付け部分の少なくとも一部分との機械的協動に配置される、項目８に記載の外科用器具。
（項目１０）
前記第１のカップリング部材の近位端が前記本体部分の遠位端に固定され、該第１のカップリング部材の遠位端が前記上部取り付け部分に旋回可能に固定され、前記第２のカップリング部材の近位端が該本体部部分の遠位端に固定され、該第２のカップリング部材の遠位端が前記下部取り付け部分の近位端に旋回可能に固定される、項目９に記載の外科用器具。
（項目１１）
前記関節運動ツールアセンブリが、該スプリングアームの一部分が前記窪み内に少なくとも部分的にあるとき第１の位置に離脱可能に保持され、該関節運動ツールアセンブリが、該スプリングアームが該窪みから係合を解かれるとき第２の位置にある、項目１に記載の外科用器具。
（項目１２）
所定量の力が、前記スプリングアームを前記窪みから解放する、項目１１に記載の外科用器具。
（項目１３）
前記関節運動ツールアセンブリが、使い捨て可能な装填ユニットの一部分である、項目１に記載の外科用器具。
（項目１４）
前記関節運動ツールアセンブリが、カートリッジアセンブリおよびアンビルアセンブリを含む、項目１に記載の外科用器具。
（項目１５）
前記本体部分がハウジング部分を収容するスリーブを含み、該本体部分が該ハウジング部分上に形成される突出部の少なくとも一部分を受容するような寸法である切り抜きを含む、項目１に記載の外科用器具。
（項目１６）
前記突出部を前記切り抜き内に少なくとも部分的に位置決めすることが、前記スリーブ内の前記ハウジング部分の実質的な軸方向の移動および回転移動を防ぐ、項目１５に記載の外科用器具。
（項目１７）
移動可能ハンドルを含むハンドル部分であって、作動ストロークを通って移動可能であるハンドル部分と、
該ハンドル部分から遠位側に延び、第１の長手方向軸を定義する本体部部分と、
該本体部分の遠位端との離脱可能な係合のための形態である使い捨て可能な装填ユニットとを備え、該使い捨て可能な装填ユニットは、
近位本体部分と、
その中に窪みを有し、第２の長手方向軸を定義する関節運動ツールアセンブリであって、該近位本体部分の遠位端に隣接して配置され、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動するまで離脱可能に保持する少なくとも１つのカップリング部材とを含む、
外科用ステープル留めデバイス。
（項目１８）
前記関節運動ツールアセンブリの近位端が、取り付けアセンブリを含み、前記窪みが、該取り付けアセンブリの一部分中に形成される、項目１７に記載の外科用ステープル留めデバイス。
（項目１９）
第１のカップリング部材および第２のカップリング部材を含み、前記取り付けアセンブリが、下部取り付け部分に旋回可能に固定された上部取り付け部分を含み、該第１のカップリング部材が該上部取り付け部分の一部分に旋回可能に固定され、該第２のカップリング部材が該下部取り付け部分の一部分に旋回可能に取り付けられる、項目１８に記載の外科用ステープル留めデバイス。
（項目２０）
外科用器具との離脱可能な係合のための形態の使い捨て可能な装填ユニットであって、
第１の長手方向軸を定義する本体部分と、
該本体部分の遠位側に配置され、その中に窪みを有し、該本体部分の遠位端に固定され、そして第２の長手方向軸を定義する関節運動ツールアセンブリであって、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動させるまで離脱可能に保持する少なくとも１つのカップリング部材とを備える、使い捨て可能な装填ユニット。
（項目２１）
前記関節運動ツールアセンブリは、前記スプリングアームの一部分が前記窪み内に少なくとも部分的にあるとき第１の位置にあり、該関節運動ツールアセンブリは、該スプリングアームが該窪みから離れるとき第２の位置にある、項目２０に記載の使い捨て可能な装填ユニット。
（項目２２）
所定量の力の付与が、前記スプリングアームを前記窪みから解放する、項目２１に記載の使い捨て可能な装填ユニット。
（概要）
本開示は、ハンドル部分、本体部分、関節運動ツールアセンブリおよび少なくとも１つのカップリング部材を含む外科用器具に関する。この本体部部分は、上記ハンドル部分から遠位側に延び、そして第１の長手方向軸を定義する。上記関節運動ツールアセンブリは、第２の長手方向軸を定義し、そしてその中に少なくとも１つの窪みを含む。この関節運動ツールアセンブリは、上記本体部分の遠位端に配置され、そして上記第２の長手方向軸が上記第１の長手方向軸と実質的に整列される第１の位置から、少なくとも上記第２の長手方向軸が第１の長手方向軸と角度をなす第２の位置まで移動可能である。上記カップリング部材は少なくとも１つのスプリングアームを有し、そして上記本体部分の一部分に固定可能である。上記スプリングアームの少なくとも一部分は、上記関節運動ツールアセンブリの窪みに受容可能であり、この少なくとも１つのスプリングアームを外方に曲げるに十分な所定量の力が上記ツールアセンブリに付与され、このツールアセンブリを関節運動するまで上記関節運動ツールアセンブリを第１の位置に離脱可能に保持する。
本開示の１つの実施形態では、上記関節運動ツールアセンブリの近位端は、取り付けアセンブリを含み、そしてその中に窪みを含む。この取り付けアセンブリ（これは、上部部分および下部部分を含み得る）の一部分が、上記本体部分の遠位端に旋回可能に固定され、そして上記関節運動ツールアセンブリの一部分に固定して取り付けられることが開示される。実施形態では、上記第１の長手方向軸に垂直な軸の周りの上記取り付けアセンブリの一部分の旋回移動が、上記関節運動ツールアセンブリを上記第１の位置と上記第２の位置との間で移動させる。上記カップリング部材の少なくとも一部分が上記本体部分の一部分に固定可能であり、そして上記カップリング部材の少なくとも一部分が、上記取り付けアセンブリの少なくとも一部分に旋回可能に固定可能であることがまた、開示される。
別の実施形態では、上記少なくと１つのカップリング部材は、第１のカップリング部材および第２のカップリング部材を含む。ここで、各カップリング部材は、上記関節運動ツールアセンブリの少なくとも一部分および上記本体部分の少なくとも一部分との機械的協動にある。この実施形態はまた、取り付けアセンブリが上部取り付け部分および下部取り付け部分を含み、そして上記関節運動するツールアセンブリの近位端上に支持されることが開示される。上記第１のカップリング部材は上記上部取り付け部分の少なくとも一部分と機械的協動にあり、そして上記第２のカップリング部材は上記下部取り付け部分の少なくとも一部分との機械的協動に配置される。
別の実施形態では、上記関節運動ツールアセンブリは、上記スプリングアームの一部分が上記窪み内に少なくとも部分的にあるとき第１の位置に離脱可能に保持され、そして上記関節運動ツールアセンブリは、上記スプリングアームが上記窪みから係合を解かれるとき第２の位置にある。所定量の力が、上記スプリングアームを上記窪みから解放することが開示される。
上記関節運動ツールアセンブリが、使い捨て可能な装填ユニットの一部分であることが開示される。実施形態では、上記関節運動ツールアセンブリは、カートリッジアセンブリおよびアンビルアセンブリを含む。
本開示はまた、ハンドル部分、本体部分および使い捨て可能な装填ユニットを含む外科用ステープル留め装置に関する。このハンドル部分は、作動ストロークを通って移動可能であるハンドル部分を含む。上記本体部分は、上記ハンドル部分から遠位側に延び、そして第１の長手方向軸を定義する。上記使い捨て可能な装填ユニットは、上記本体部分の遠位端との離脱可能な係合のための形態であり、そして近位本体部分、関節運動ツールアセンブリ、および少なくとも１つのカップリング部材を含む。この関節運動ツールアセンブリは、その中に窪みを有し、第２の長手方向軸を定義し、上記近位本体部分の遠位端に隣接して配置され、そして上記第２の長手方向軸が上記第１の長手方向軸と実質的に整列される第１の位置から少なくとも上記第２の長手方向軸が上記第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である。上記少なくとも１つのカップリング部材は、少なくとも１つのスプリングアームを含み、そして上記本体部分の一部分に固定可能である。上記スプリングアームの少なくとも一部分は、上記関節運動ツールアセンブリの窪み中に受容可能であり、上記関節運動ツールアセンブリを上記第１の位置に、上記少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力がこのツールアセンブリに付与され、このツールアセンブリを関節運動するまで離脱可能に保持する。
本開示はまた、外科用器具との離脱可能な係合のための形態の使い捨て可能な装填ユニットに関する。この使い捨て可能な装填ユニットは、本体部分、関節運動するツールアセンブリおよび少なくとも１つのカップリング部材を含む。
（摘要）
ハンドル部分、本体部分、関節運動ツールアセンブリおよび少なくとも１つのカップリング部材を含む外科用器具が開示される。この本体部部分は、上記ハンドル部分から遠位側に延び、そして第１の長手方向軸を定義する。上記関節運動ツールアセンブリは、第２の長手方向軸を定義し、そしてその中に少なくとも１つの窪みを含む近位端を有する。この関節運動ツールアセンブリは、上記本体部分の遠位端に固定可能であり、そして上記第１および第２の長手方向軸が実質的に整列される第１の位置から、少なくともこれら第１の軸および第２の長手方向軸が角度をなす第２の位置まで移動可能である。上記カップリング部材は少なくとも１つのスプリングアームを有し、そして上記本体部分に固定可能である。上記スプリングアームの少なくとも一部分は、上記関節運動ツールアセンブリの窪みに受容可能であり、上記関節運動ツールアセンブリを第１の位置に離脱可能に保持する。
本明細書に開示される外科用器具の種々の実施形態は、図面を参照して本明細書中に開示される。
（実施形態の詳細な説明）
本明細書で開示される外科用器具およびＤＬＵの実施形態を、ここで図面を参照して詳細に説明し、図面では、同様の参照番号は、いくつかの図面の各々で同一または対応する要素を指定する。
図１を参照して、外科用器具の遠位端５００は、ハンドル部分５１０、本体部分５１２、および使い捨て可能な装填ユニット（「ＤＬＵ」）１６を含む。ハンドル部分５１０は、静止ハンドル５１４および移動可能ハンドルまたはトリガー５１６を含む。移動可能ハンドル５１６は、静止ハンドル５１４に対して移動可能であり、本体部分５１２の遠位端から突出する制御ロッド５２０を進行する。ハンドル部分５１０および本体部部分５１２は、米国特許第６，３３０，９６５号に開示される様式で構築され得、この特許は、本明細書によってその全体が参考として本明細書中に援用される。あるいは、その他の外科用器具がＤＬＵ１６とともに用いられ得、内視鏡外科的手順を実施する。
図１および１Ａを参照して、簡単に述べれば、ＤＬＵ１６は、ツールアセンブリ１７、近位本体部分２００およらび取り付けアセンブリ２０２を含む。本体部分２００は、以下に詳細に論議される様式で外科用器具の遠位端５００を離脱可能に係合するように適合された近位端を有する（図１１）。取り付けアセンブリ２０２は、本体部分２００の遠位端に旋回可能に取り付けられ、そしてツールアセンブリ１７の近位端に固定して取り付けられる。本体部分２００の長手方向軸に垂直な軸の周りの取り付けアセンブリ２０２の旋回移動は、ツールアセンブリ１７の長手方向軸が本体部分２００の長手方向軸と整列される非関節運動位置と、ツールアセンブリ１７の長手方向軸が本体部分２００の長手方向軸に足して所定の角度で配置される関節運動位置との間のツールアセンブリ１７の関節運動に影響する。
図２〜４を参照して、ツールアセンブリ１７は、カートリッジアセンブリ１８およびアンビルアセンブリ２０を含む。アンビルアセンブリ２０は、複数のステープル変形窪み３０を有するアンビル部分２８（図４）およびアンビル部分２８の上面に固定されたカバープレート３２を含む。カバープレート３２およびアンビル部分２８は、それらの間に窪み３４を定義し（図４）、これは、駆動アセンブリ２１２の遠位端を受容するような寸法である（図３）。カバープレート３２は、駆動アセンブリ２１２の遠位端を取り囲み、ＤＬＵ１６の作動の間に組織をつまむことを防ぐ。長手方向スロット３８が、アンビル部分２８を通って延び、駆動アセンブリ２１２の保持フランジ４０の通過を容易にする。アンビル部分２８上に形成されたカム作用面４２は、駆動アセンブリ２１２の保持フランジ４０上に支持された一対のカム部材４０ａを係合するように位置決めされ、アンビルアセンブリとカートリッジアセンブリとの接近を行う。一対の旋回部材４４が形成される。一対の安定化部材５０がキャリヤ４８上に形成された個々のショルダー５２を係合し、カム作用面４２が旋回部材４４の周りで旋回されるとき、アンビル部分２８がステープルカートリッジ５４に対して軸方向に滑動することを防ぐ。
カートリッジアセンブリ１８は、ステープルカートリッジ５４を受容するような寸法および形態である細長い支持チャネル５６を定義するキャリヤ４８を含む。ステープルカートリッジ５４および細長い支持チャネル５６に沿ってそれぞれ形成される対応するタブ５８およびスロット６０は、ステープルカートリッジ５４を支持チャネル５６内の固定された位置に保持するように機能する。ステープルカートリッジ５４上に形成された一対の支持支柱６２は、キャリヤ４８の側壁上に静止するように位置決めされ、支持チャネル５６内でステープルカートリッジ５４をさらに安定化する。キャリヤ４８は、アンビル部分２８の旋回部材４４を受容し、そしてアンビル部分２８を間隔が置かれた位置と接近された位置との間を移動させるためのスロット４６を有する。
ステープルカートリッジ５４は、複数のステープルまたはファスナー６６およびプッシャー６８を受容するための保持スロット６４を含む（図２）。複数の側方に間隔を置かれて離れた長手方向スロット７０は、ステープルカートリッジ５４を通って延び、作動スレッド７４の直立するカムウェッジ７２を収容する（図２）。中央の長手方向スロット７６は、ステープルカートリッジ５４の実施的長さに沿って延び、ナイフブレード７８の通過を容易にする（図４）。外科用ステープラー１０の作動の間に、駆動アセンブリ２１２は作動スレッド７４と接し、そして作動スレッド７４をステープルカートリッジ５４の長手方向スロット７０を通って押し、カムウェッジ７２をプッシャー６８との連続的接触に進める。プッシャー６８は、ファスナー保持スロット６４内でカムウェッジ７２に沿って垂直に転移し、そしてファスナー６６を保持スロット６４からアンビルアセンブリ２０のステープル変形窪み３０中に押す（図４）。
図３を参照して、取り付けアセンブリ２３５は、上部取り付け部分２３６および下部取り付け部分２３８を含む。中央に位置される旋回部材２８４は、上部取り付け部分２３６から第１のカップリング部材２４６中に形成された個々の開口部２４６ａを通って延びる。下部取り付け部分２３８は、旋回部材２８４を受容するためのボア２３９を含む（図３Ｆを参照のこと）。旋回部材２８４は、ボア２３９および第２のカップリング部材２４７の開口部２４７ａを通って延びる。カップリング部材２４６、２４７の各々は、上部ハウジング半分体２５０および下部ハウジング半分体２５２から形成される内部ハウジングの遠位端に形成された溝２９０内に受容される形態である相互ロックする近位部分２４６ｂ、２４７ｂを含む。カップリング部材２４６、２４７は、取り付けアセンブリ２３５ならびに上部ハウジング半分体２５０および下部ハウジング半分体２５２を、互いに対して長手方向の固定された位置に保持し、その一方、それに対する取り付けアセンブリ２３５の旋回移動を可能にする。
図３Ａ〜３Ｃを参照して、各カップリング部材２４６、２４７は、取り付けアセンブリ２３５を係合するために位置決めされる遠位端２４６ｄを有する片持ちスプリングアーム２４６ｃを含む。より詳細には、上部取り付け部分２３６は、個々のカップリング部材２４６のスプリングアーム２４６ｃの遠位端２４６ｄを受容するような寸法の窪み２３６ｂを含む上面２３６ａを含む。下部取り付け部分２３８は、個々のカップリング部材２４７のスプリングアーム２４７ｃを受容するような寸法である窪み２３８ｃを定義する一対の高くなった面２３８ｂを有する底面２３８ａを含む。あるいは、少なくとも１つの窪みがツールアセンブリ１７の近位端に形成され得る。
図３Ｄ〜３Ｇに示されるように、カップリング部材２４６、２４７のスプリングアーム２４６ｃ、２４７ｃの遠位端が上部取り付け部分２３６および下部取り付け部分２３８の窪み２３６ｂおよび２３８ｃ中にそれぞれ位置決めされるとき、スプリングアーム２４６ｃ、２４７ｃは、取り付けアセンブリ２３５を非関節運動位置に保持する。スプリングアーム２４６ｃ、２４７ｃは、スプリングアーム２４６ｃを窪み２３６ｂおよび２３８ｃから曲げるに十分な所定の力が取り付けアセンブリ２３５およびツールアセンブリ１７の関節運動を行うために付与されるまで、取り付けアセンブリ２３５を非関節運動位置に保持する。この所定の力が取り付けアセンブリ２３５およびツールアセンブリ１７に付与されるとき、スプリングアーム２４６ｃ、２４７ｃは、図３Ｅおよび３Ｇに示されるように、窪み２３６ｂおよび２３８ｃから外方に跳ねるか、または曲がって、ＤＬＵ１６の近位本体部分２００の遠位端に対する取り付けアセンブリ２３５（そしてそれ故、ツールアセンブリ１７）の旋回移動を可能にする。
上記で論議されたように、スプリングアーム２４６ｃならびに窪み２３６ｂおよび２３８ｃは、ツールアセンブリ１７を、所定の力が取り付けアセンブリ２３５に付与され、スプリングアーム２４６ｃ、２４７を取り付けアセンブリ２３５の窪み２３６ｂおよび２３８ｃから解放するまで、その非関節運動位置に維持する。これらスプリングアーム／窪みは、ステープラー、把持器（図３Ｈを参照のこと）、電力によるシールデバイス、例えば、ＲＦ封止デバイスなどを含む任意の関節運動する外科用デバイス中に組み込まれ得ることが想定される。さらに、２つのスプリングアーム／窪みが示されているけれども、単一のスプリングアームが提供され得る。さらに、上記関節運動するツールアセンブリは、ＤＬＵのパーツを形成する必要はなく、むしろ、外科用器具の遠位端上に直接支持され得る。例えば、この取り付けアセンブリは、上記ツールアセンブリに離脱可能または離脱不能に固定され得、そして外科用器具の遠位端に直接固定され得る。
上部ハウジング半分体２５０および下部ハウジング半分体２５２は、本体部分２００の外側スリーブ２５１内に含まれる（図３）。本体部分２００は、上部ハウジング半分体２５０上に形成されたボスまたは突出部２５０ａを受容するような寸法である切り抜き２５１ａを含む。切り抜き２５１ａ内の突出部２５０ａの位置決めは、本体部分２００の外側スリーブ２５１内の上部ハウジング半分体２５０および下部ハウジング半分体２５２の軸方向および回転移動を防ぐ。１つの実施形態では、ボス２５０ａは、側方寸法より大きい軸方向寸法を有する実質的に矩形の形態を有する。このより大きな軸方向寸法は、スリーブ２５１内の上部ハウジング半分体２５０および下部ハウジング半分体２５２の回転を防ぐために増加した表面積を提供する。ボス２５０ａの近位部分２５０ｂは傾斜されている。傾斜した近位部分２５０ｂは、上部ハウジング半分体２５０および下部ハウジング半分体２５２がスリーブ２５１内に位置決めされるとき、スリーブ２５１がボス２５０ａ上で滑動されることを可能にする。ボス２５０ａは、その他の形態、例えば、円形、矩形、三角形などをとり得ることが想定され、そしてなお、その意図された機能を達成する。さらに、ボス２５０ａは、上部ハウジング半分体２５０に沿った任意の位置に再位置決めされ得るか、またはそれに代わって、下部ハウジング半分体２５２、もしくは各ハウジング半分体２５０および２５２上に部分的に位置決めされ得る。
上部ハウジング半分体２５０の近位端または挿入先端部１９３は、外科用器具の遠位端を差し込み型様式（図１Ａおよび７を参照のこと）で外科用器具の遠位端を離脱可能に係合するために係合ナブ２５４を含む。ハウジング半分体２５０および２５２は、その中に軸方向駆動アセンブリ２１２を滑動可能に受容するためのチャネル４００を定義する。関節リンク２５６は、上部ハウジング半分体２５０と下部ハウジング半分体２５２との間に形成されたスロット４０２内に滑動可能に位置決めされるような寸法である。１対のＨ−ブロックアセンブリ２５５は、ハウジング部分２００の遠位端に隣接し、かつ軸方向駆動アセンブリ２１２の遠位端に隣接して位置決めされ、外科用ステープル留め装置１０の関節運動および発射の間に、駆動アセンブリ２１２の座屈およびふくらみを防ぐ。各Ｈ−ブロックアセンブリ２５５は、本体部分２００に固定して取り付けられた近位端および取り付けアセンブリ２３５に固定して取り付けられた遠位端を含む可撓性本体２５５ａを含む（図３）。
保持部材２８８は、軸方向駆動アセンブリ２１２の係合セクション２７０上に支持される。保持部材２８８は、下部ハウジング半分体２５２中に形成されるスロットまたは窪み２５２ａ内に離脱可能に位置決めれさる一対のフィンガー２８８ａを含む。作動において、ＳＵＬＵ１６が外科用器具に取り付けられ、そして軸方向駆動アセンブリ２１２が、外科用器具５００の作動部材５１６（図１１）に所定の力を付与することによって作動されるとき、軸方向駆動アセンブリ２１２は遠位側に進行され、駆動アセンブリ２１２および保持部材２８８を遠位側に移動する。保持部材２８８が遠位側に進行されるとき、フィンガー２８８ａは窪み２５２ａから押され、外科用器具が作動されたことの音響および触覚指標を提供する。保持部材２８８は、輸送の間のような、ＤＬＵ１６の不注意の部分的作動を、所定の軸方向の力が軸方向駆動アセンブリ２１２に付与されるまで、ＤＬＵ１６内の固定された位置に軸方向駆動アセンブリ２１２を維持することによって防ぐように設計される。
軸方向駆動アセンブリ２１２は、遠位作動ヘッド２６８および近位係合セクション２７０を含む細長い駆動ビーム２６６を含む。１つの実施形態では、駆動ビーム２６６は、複数のスタックされた材料シートから構築される。係合セクション２７０は、駆動部材２７２中に形成された一対の対応する保持スロットを実装されて係合する一対の弾性係合フィンガー２７０ａおよび２７０ｂを含む。駆動部材２７２は、ＤＬＵ１６の近位端が外科用器具５００の本体部分５１２と係合されるとき、外科用器具の中央ロッド５２０（図１１）の遠位端を受容するような形態の近位ポートホール２７４を含む。
図５〜１０をまた参照して、ＤＬＵ１６は、ロック部材３００およびロック部材アクチュエーター３０２を含むロック機構をさらに含む。ロック部材３００（図６）は、ＤＬＵ１６の本体部分２００の上部ハウジング半分体２５０の近位部分中に形成された長手方向または軸方向スロット３１０（図７）内に回転可能に支持される。ロック部材３００は、ロック部材３００が駆動アセンブリ２１２を発射前位置に維持する第１の位置（図７および８）から、駆動アセンブリ２１２が軸方向に自由に移動する第２の位置（図９および１０）まで移動可能である。
図６に示されるように、ロック部材３００は、本体部分２００の上部ハウジング半分体２５０中に形成された横方向スロット３１０内に滑動可能に位置決めされる半円筒形の本体３１２を含む。本体３１２は、半径方向の内方に延びるカム部材３１４および半径方向の内方に延びるフィンガー３１６を含む。フィンガー３１６は、駆動アセンブリ２１２中に形成されたノッチまたはスロット２７０ｃ（図３）内に滑動可能に受容されるような寸法である。駆動アセンブリ２１２のノッチ２７０ｃ中のフィンガー３１６の係合は、駆動アセンブリ２１２が本体部分２００内で直線状に移動することを防ぎ、そしてそれ故、ＤＬＵ１６の作動を防ぐ。
図３、５および７を参照して、ロック部材アクチュエーター３０２は、ＤＬＵ１６の本体部分２００の上部ハウジング半分体２５０中に形成された軸方向スロット３２０（図７）内に滑動可能に位置決めされる。アクチュエーター３０２は、近位橋台部材３２２、遠位スプリングガイド３２４、および中央カムスロット３２６を含む。軸方向スロット３２０は、横方向スロット３１０と、ロック部材３００のカム部材３１４がロック部材アクチュエーター３０２のカムスロット３２６内で滑動可能に位置決めされるように交差する。付勢部材またはスプリング３２８（図７）は、アクチュエーター３０２の遠位面３３０と軸方向スロット３２０の遠位端を定義する壁３３２（図７）との間のスプリングガイド３２４の周りに位置決めれさる。スプリング３２８は、アクチュエーター３０２を軸方向スロット３２０内のその退却された位置まで押す。その退却された位置では、橋台部材３２２は、近位本体部分２００の挿入先端部１９３に隣接するＤＬＵ１６の近位端上に位置決めされ、そして半径方向の外方に延び、そしてカムスロット３２６は、カム部材３１４を、ロック部材３００のフィンガー３１６が駆動アセンブリ２１２のノッチ２７０ｃ内に位置決めされるように位置するよう位置決めされる。
図１１〜１５は、ＤＬＵ１６の外科用器具５００への取り付け前、およびその間のＤＬＵ１６および外科用器具５００を示す。ＤＬＵ１６の外科用デバイス５００への取り付けの前に、スプリング３２８はアクチュエーター３０２をその退却された位置に押し、上記で論議されたように、ロック部材３００をそのロック位置に移動する。ＤＬＵ１６の挿入先端部１９３が外科用器具５００の本体部分５１２（図１３）の開放端部５２２（図１１）中に直線状に挿入されるとき、ナブ２５４は、本体部分５１２の開放端部５２２中に形成されたスロット（図示せず）を通って直線状に移動する。ナブ２５４がこれらのスロットを通過するとき、ナブ２５４から角度がオフセットされている橋台部材３２２の近位端３２２ａは、ナブ２５４を受容するためのスロットを定義する壁２７６ｃに接する。ＤＬＵ１６が本体部分５１２中にさらに移動されるとき、ロック部材アクチュエーター３０２は、その退却された位置からその進行された位置に図１４中矢印「Ｔ」で示される方向に移動される。アクチュエーター３０２がその進行された位置まで移動されるとき、ロック部材３００は、駆動アセンブリ２１２と係合されるそのロック位置（図８）からノッチ２７０ｃからフィンガー３１６を移動するその非ロック位置（図１０）まで図１４中矢印「Ｕ」によって示される方向にカム移動される。ロック部材３００およびロック部材アクチュエーター３０２を含む上記ロック機構は、ＤＬＵ１６の外科用器具５００上への装填の間などで、ＤＬＵ１６の駆動部材の偶発的または不注意の進行または操作を防ぐ。
ＤＬＵ１６が器具５００に対して直線状に、本体部分２００の近位面５３０が本体部分５１２（図１５）の内面２７６ｃに接する位置まで移動されるとき、ＤＬＵ１６は、本体部分５１２の開口部５３６内にナブ２５４を位置決めするような差し込みタイプ作用で本体部分５１２に対して回転され得、ＤＬＵ１６を本体部分５１２上にロックする。差し込みカップリングの他のその他のカップリングタイプがＤＬＵ１６を器具５００に連結するために用いられる得ることが想定され、例えば、スプリング移動止めまたはスナップばめカップリング、摩擦ばめカップリング、相互ロック部材、ねじ山カップリングなどがある。
図１６〜２０に示される本開示の実施形態では、ロックアセンブリ６００は、外科用器具５００および使い捨て可能な装填ユニット１６（例えば、図１を参照のこと）との使用のために示される。示される実施形態では、ロックアセンブリ６００は、ハウジング６０２、プッシャー６０４、ロッド６０６、スライド６０８、少なくとも１つのスプリング６１０、カムフィンガー６１２、スロット６１６を有する旋回プレート６１４およびリング６１８を含む。ロックアセンブリ６００は、一般に、ツールアセンブリ１７（例えば、図１を参照のこと）を外科用器具５００の発射の間にその位置を維持することを支援する。
図１６および１７を参照して、ロックアセンブリ６００の一部分は、少なくとも部分的にハウジング６０２内に含まれる。図１６は、ハウジング６０２に対して配置されるロックアセンブリ６００を示し、その一方、図１７は、ハウジング６０２から隔離されたロックアセンブリ６００を示す。図１７の示される実施形態では、プッシャー６０４がそれから遠位側に延びるロッド６０６とともに示される。スライド６０８はロッド６０６から遠位側に延び、そしてそれと滑動可能な関係にあり、それ故、スライド６０８がロッド６０６に対して軸方向に移動することを可能にする。スプリング６１０または対のスプリング（この実施形態では明瞭に示されてはいない）は、スライド６０８をロッド６０６から遠位側に付勢する。
ここで図１８〜２０を参照して、カムフィンガー６１２および旋回プレート６１４が示される。カムフィンガー６１２はスライド６０８から遠位側に延び、そして旋回プレート６１４は、例えば、取り付けアセンブリ２３５上に配置され得る（図３を参照のこと）。旋回プレート６１４は、ツールアセンブリ１７の一部分上に配置され得るか、またはそれと一体化され得る。複数のスロット６１６（５つのスロット６１６が示される）が旋回プレート６１４上に配置され、そしてその中にカムフィンガー６１２の少なくとも一部分を受容するようなサイズである。本体部分５１２（例えば、図１を参照のこと）に対する異なる量のツールアセンブリ１７の関節運動に際し（実質的な関節運動がない場合を含む）、カムフィンガー６１２は、旋回プレート６１４の個々のスロット６１６とほぼ整列される。図１８および１９は、中央スロット６１６ａ（図１９では視野から隠されている）と実質的に整列されるカムフィンガー６１２を示し、そして図２０は、側方スロット６１６ｂと実質的に整列されるカムフィンガー６１２を示す。
図１７および１９に示されるリンク６１８は、旋回プレート６１４およびカムフィンガー６１２との機械的係合にある。（図１８では、このリングは除かれている。）リンク６１８は、開口部６２０およびスロット６２２を有して示される（図１９）。開口部６２０は、旋回プレート６１４上のボス６２４と旋回関係にあり、そしてスロット６２２はカムフィンガー６１２と滑動可能に係合される。この関係は、本体部分５１２に対する旋回プレート６１４の関節運動および旋回プレート６１４に対するスライド６０８の長手方向転移を可能にする。
作動において、移動可能ハンドル５１６（例えば、図１を参照のこと）の少なくとも部分的な作動に際し、プッシャー６０４は、例えば、制御ロッド５２０（例えば、図１１を参照のこと）を経由して遠位側に押され、それ故、旋回プレート６１４のスロット６１６中に少なくとも部分的なカムフィンガー６１２の遠位側転移を引き起こす。カートリッジアセンブリ１８およびアンビルアセンブリ２０（例えば、図１Ａを参照のこと）を接近するように移動可能ハンドル５１６を作動することまた、カムフィンガー６１２を遠位側に転移するように機能する。このような実施形態では、関節運動するツールアセンブリ１７がその場にあり、そして組織上でクランプされるとき、さらなる関節運動は（例えば、移動可能ハンドル５１６を開放することなく）達成されることはできない。それ故、ロックアセンブリ６００は、例えば、ステープルを組織に据え付ける前に本体部分５１２に対して関節運動するツールアセンブリ１７をその場に支援して維持する。
上記で論議されたように、スプリング６１０は、ロッド６０６からスライド６０８を遠位側に付勢する。スプリング６１０によって提供されるこの付勢は、カムフィンガー６１２が旋回プレート６１４のスロット６１６から偶発的または時期尚早に外れないことを支援して確実にし、これは、それらの間に顕著な量の「遊び」を生じ得る。さらに、スプリング６１０によって提供される遠位側の付勢は、スライド６０８と旋回プレート６１４との間に存在する製造許容誤差および／または間隙を支援して無くする。カムフィンガー６１２および／またはスロット６１６のすくなとも一部分は、くさび形状であり得、それらの間の意図されない移動を支援して減少する。このような実施形態では、カムフィンガー６１２の遠位部分およびスロット６１６は、対応する近位部分よりは狭くあり得る。
図２１および２２に示される本開示の実施形態では、ロックアセンブリ７００が、外科用器具５００およひ使い捨て可能な装填ユニット１６（例えば、図１を参照のこと）との使用のために示される。示される実施形態では、ロックアセンブリ７００は、アダプター７０２、プッシャー７０４、ピボット７０６、付勢要素（例えば、一対のスプリング７０８）およびリンク７１０を含む。ロックアセンブリ７００は、一般に、ツールアセンブリ１７を所定の位置に支援して維持する。
図２１を参照して、ロックアセンブリ７００のアダプター７０２は、一般に、外科用器具５００の本体部分５１２内（例えば、図１を参照のこと）、または使い捨て可能な装填ユニット１６内に収容される。示される実施形態では、プッシャー７０４は、一対のスプリング７０８の遠位側に位置される。プッシャー７０４は、対のスプリング７０８を経由して関節運動するツールアセンブリ１７のピボット７０６に向かって遠位側に付勢される。プッシャー７０４の遠位部分は、ピボット７０６の近位部分に隣接して配置された旋回嵌合面７１４（図２２）と嵌合するような形状および寸法であるプッシャー嵌合面７１２（図２２）を含む。リンク７１０は、プッシャー７０４の一部分と機械的協動し、そしてピボット７０６の一部分に旋回可能に連結されて示され、それ故、ツールアセンブリ１７が本体部分５１２に対してその第１の位置とその第２の位置との間で移動することを可能にする。より詳細には、リンク７１０は、ピボット７０６の突出部７０７上に適合する開口部７１１を含み、それ故、それらの間の旋回移動を可能にする。さらに、リンク７１０は、アダプター７０２の一部分と滑動可能に係合し、それ故、それらの間の長手方向移動を可能にする。
ここで、図２２を参照して、プッシャー嵌合面７１２は、この実施形態では、その長さの大部分に沿って実質的に平坦である。対応して、旋回嵌合面７１４もまた、示された実施形態ではその長さの大部分に沿って平坦である。従って、スプリング７０８の対を経由するピボット７０６に向かうプッシャー７０４の（矢印Ａの方向の）遠位側付勢は、関節運動するツールアセンブリ１７をその第１の非関節運動位置に支援して維持する。なぜなら、この付勢力が、ツールアセンブリ１７が旋回することに抵抗することを助けるからである。２つのスプリング７０８が示されているけれども、より多くまたはより少ないスプリング７０８が提供され得る。
関節運動ツール１７をその第１の非関節運動位置から旋回するために、対のスプリング７０８からの遠位側付勢力が克服されなければならない。このような旋回する作用は、プッシャー７０４を、対のスプリング７０８の付勢に対して近位側（矢印Ｂの方向）に移動する。プッシャー嵌合面７１４は、選択された関節運動位置で関節運動する顎部材１７を支援して安定化するために移動止めを含む（この実施形態では明瞭に示されていない）。
図２２を続いて参照し、ピボット７０６はその上にシェルフ７１６を含む。図２２に示されるように、シェルフ７１６は、プッシャー嵌合面７１２がピボット嵌合面７１４と接触しているとき、プッシャー７０４の少なくとも一部分と重複する。シェルフ７１６は、関節運動ツールアセンブリ１７が回転そして／または関節運動されるとき、組織がプッシャー７０４とピボット７０６との間でつままれることを支援して防ぐような位置および形態にある。
図２３〜２５に示される本開示の実施形態では、複数の層７５０ａ〜７５０ｅを有する複数層の駆動ビーム７５０が示され、そして使い捨て可能な装填ユニット１６（例えば、図１を参照のこと）中に含められ得る。Ｉ−ビームのような閉鎖装置７６０もまた示される。閉鎖装置７６０は、図２を参照して上記に詳細に記載されたように、ツールアセンブリ１７に接近するためにカム作用面４２（またはその他の接触面）に進行可能である水平部分７６２を含む。
図２４を参照して、５つの層７５０ａ〜７５０ｅを有する複数層の駆動ビーム７５０が示される。複数層の駆動ビーム７５０を形成するためにより少ないかまたはより多くの層が用いられ得ることが想定され、そして本開示の範囲内である。複数層の駆動ビーム７５０が本開示のその他の実施形態における駆動ビーム２６６を置き換え得ることもまた想定される。複数層の駆動ビーム７５０の使用は、使用の間に、特に、例えば、ツールアセンブリ１７が関節運動位置にある間に、増加した強度および可撓性を提供し得る。
複数の切り抜き７７０が図２３〜２５に示され、これらは、複数層の駆動ビーム７５０の各層を通って延びる。これらの図は、複数層の駆動ビーム７５０の層あたり５〜１０の間の切り抜きを示しているが、切り抜き７７０の正確な数は、５より少なく、５〜１０の間、または１０より大きくあり得る。さらに、駆動ビーム７５０の隣接する層の切り抜き７７０は、互いと整列しても良いし、しなくても良い。切り抜き７７０の使用は、駆動ビーム７５０の断面積を減少し、そして曲け力の調節を可能にする。矩形の切り抜き７７０が示されるが、その他の規則的または不規則的形状を有する切り抜き７７０の使用もまた企図される。
複数層の駆動ビーム７５０の各層７５０ａ〜７５０ｅの取り付け、および閉鎖装置７６０への取り付けは、図２５に示される。示される実施形態では、外側層（図２４の７５０ａまたは７５０ｅ）は、例えば、一対のスポット溶接を経由して２つの位置（各位置は、図２５で数字７８０によって示されている）で閉鎖装置７６０に固定される。各外側層７５０ａ、７５０ｅは、閉鎖装置７６０から突出するボス７７８上に適合するアパーチャ７７６を含むことがまた想定される。外側層７５０ａ、７５０ｅはまた、おそらくは、一対のスポット溶接を経由して２つの位置（各位置は、図２５で数字７８１によって示されている）で隣接層（例えば、７５０ｂまたは７５０ｄ）に固定される。さらに、各内側層（例えば、７５０ｂ、７５０ｃおよび７５０ｄ）は、例えば、スポット溶接を経由して２つの位置で隣接内側層に付着される（例えば、７５０ｂは７５０ｃに付着され；７５０ｃは７５０ｂおよび７５０ｄに付着され；そして７５０ｄは７５０ｃに付着される）。スポット溶接が付着方法として開示されているけれども、各層を互いに、そして外層を閉鎖装置に付着するためのその他の方法が想定され、そして本開示の範囲内である。示される実施形態は、閉鎖装置７６０に隣接する内側層の付着点７８０を示すが、付着点７８０が駆動ビーム７５０のその他の位置に配置されることが想定され、そして本開示の範囲内である。さらに、駆動ビーム７５０の少なくとも１つの層がステンレス鋼のような金属から作製されることが想定される。駆動ビーム７５０および／または閉鎖装置７６０の部分はまた、以下に説明されるように、プラスチック材料から作製され得るか、または少なくとも部分的にプラスチック材料で被覆され得る。さらに、閉鎖装置７９０は、組織を切断するためにその上に切断面７６６（図２３）を含み得る。
図２６および２７に示される本開示の実施形態では、閉鎖装置８００および駆動ビーム８０２の一部分が示される。閉鎖装置および／またはツールアセンブリ１７（例えば、図２を参照のこと）の接触面（例えば、カム作用面４２）は、プラスチック面またはプラスチック被覆を含み得る。この実施形態では、閉鎖装置８００は、閉鎖装置８００の水平部分８０６を少なくとも部分的に被覆する一対のキャップ８０４を有して示される。キャップ８０４は、この実施形態ではプラスチックから作製され得る。閉鎖装置８００および／またはツールアセンブリ１７の接触面上に配置されるこのようなプラスチック面は、一般に、２つの金属面に対してそれらの間の摩擦の量を低減する。すなわち、金属に対するプラスチック、またはプラスチックに対するプラスチック相互作用は、一対の金属面の間の相互作用より少ない摩擦を生成し得る。この低減された摩擦の量は、低減された発射力に対応し得る。
対のキャップ８０４のような閉鎖装置８００の一部分は、プラスチックでオーバーモールドされたプラスチックから作製されるか、またはプラスチック被覆を含む。さらに、ツールアセンブリ１７の接触面、または少なくともその一部分もまた、プラスチックから作製され得るか、またはプラスチック被覆を含み得る。
本開示の実施形態では、閉鎖装置８００は、図２６および２７に示されるうようにＩ−形状断面を含み得る。さらに、閉鎖装置８００および駆動ビーム８０２は、使い捨て可能な装填ユニット１６のパーツおよび／または関節運動し得る外科用器具５００のパーツであり得る。さらに、駆動ビーム８０２は、単一の層または（図２６に示されるような）複数の層を含み得、そして駆動ビーム８０２の少なくとも一部分は、プラスチックから作製され得る。なおさらに、閉鎖装置８００は、組織を切断するためにその上に切断面８０８（図２７）を含み得る。
図２６および２７を続いて参照し、プラスチックキャップ８０４は、閉鎖装置８００の強度を増加し得るか、またはキャップ８０４と閉鎖装置８００の水平部分８０６との間でより強力な連結を提供し得る補強セクション８１０を含み得る。キャップ８０４は、閉鎖装置８００に離脱可能に取り付けられ得ることもまた想定される。このような実施形態では、キャップ８０４は、任意の実質的な摩耗または損傷が生じる場合に、除去および置換され得る。
図２８および２９に示される本開示の実施形態では、ツールアセンブリ８５０が示される。この実施形態のツールアセンブリ８５０は、チャネル８５２、第１の取り付け部材８６０、第２の取り付け部材８７０、アンビルアセンブリ８８０、第１の取り付けロッド８９０および第２の取り付けロッド８９２を含む。第１の取り付けロッド８９０および第２の取り付けロッド８９２は、ツールアセンブリ８５０の要素が一緒に残ることを容易にする強力な連結を提供する。
チャネル８５２は、その近位端に隣接する開口部８５４（２つの開口部が示される）を含み、そして第１の取り付け部材８６０はそれから延びるボス８６２を含む（２つのボスが示される）。チャネル８５２は、第１の取り付け部材に開口部（単数または複数）８５４をボス（単数または複数）８６２上に配置することにより連結可能であり、それ故、それらの間に旋回連結を提供する。本開示では明瞭に示されていないけれども、チャネル８５２は、複数の外科用ファスナーまたはステープルカートリッジを収容し得る。
アンビルアセンブリ８８０は、アンビルカバー８８２およびアンビル８８６を含む。アンビル８８６は、例えば、スナップばめ連結を経由してアンビルカバー８８２との機械的係合のための形態である。アパーチャ８８４は、アンビルカバー８８２の一部分を少なくとも部分的に通って延びる。アパーチャ８８４は、第２の取り付け部材８７０上に配置された突出部８７２上に適合する形態であり、それによって、アンビルアセンブリ８８０と第２の取り付け部材８７０との間の連結を提供する。さらに、アンビルカバー８８２は、この開示の実施形態ではそれを通って少なくとも部分的に延びる少なくと１つの開口部８８８を含む。開口部８８８は、第１の取り付け部材８６０のボス８６２上に適合するような形態である。このような実施形態では、アンビルアセンブリ８８０は、第１の取り付け部材８６０および第２の取り付け部材８７０に対して旋回され得る。
第１の取り付け部材８６０は、それから延びる第１の開口部８６４および第２の開口部８６６を含む。第２の取り付け部材８７０はまた、それから延びる第１の開口部８７４および第２の開口部８７６を含む（図２９）。さらに、第１の取り付け部材８６０および第２の取り付け部材８７０は、第１の開口部８６４、８７４が実質的に整列し、そして第２の開口部８６６、８７６が実質的に整列するような機械的係合にある。
第１の取り付け部材８６０を第２の取り付け部材８７０と（そしてそれ故、チャネル８５２とアンビルアセンブリ８８０とを）固定するために、第１の取り付けロッド８９０、またはその一部分は、第１の開口部８６４および８７４を通って挿入される。ツールアセンブリ８５０の要素をさらに固定するために、第２の取り付けロッド８９２またはその一部分が、第２の開口部８６６および８７６を通って挿入される。第１の取り付けロッド８９０および／または第２の取り付けロッド８９２が、締め付け可能な２部分リベットのようなリベットであることが想定される。
本開示の実施形態では、ツールアセンブリ８５０は、これもまた関節運動し得る、使い捨て可能な装填ユニットのパーツである。ツールアセンブリ８５０の関節運動は、第２の取り付け部材８７０から延びる突出部８７４および（図２１中のリンク７１０のような）リンクを経由して外科用器具の本体部分にツールアセンブリ８５０を旋回可能に取り付けることによって容易にされ得る。さらに、上記で説明されるように、ツールアセンブリ８５０を組み立てる方法は、本開示によって企図される。
本明細書に開示される実施形態に種々の改変がなされ得ることが理解される。例えば、上記に記載のロックアセンブリは、ＤＬＵを含む種々の外科用器具に取り込まれ得、そして直線状ステープラーに関する使用に制限されない。さらに、このＤＬＵは、開示されるのとは対照的に外科用器具の挿入先端部を受容する形態であり得る。従って、上記の説明は、制限するものと解釈されるべきではなく、種々の実施形態の単なる例示である。当業者は、本明細書に添付された請求項の範囲および思想内でその他の改変を想定する。
図１は、関節運動するツールアセンブリを備えた本明細書に開示される外科用器具の１つの実施形態の遠位端からの側方斜視図である。 図１Ａは、ツールアセンブリを含む図１に示される外科用器具の近い捨て可能な装填ユニット（ＤＬＵ）の近位端からの側方斜視図である。 図２は、図１に示される外科用器具のＤＬＵのパーツを分離して、取り付けアセンブリの遠位端とツールアセンブリの遠位端の側方斜視図である。 図３は、パーツを分離して図１Ａに示される取り付けアセンブリおよびＤＬＵの近位本体部分の側方斜視図である。 図３Ａは、図１に示される外科用器具のカップリング部材の側方斜視図である。 図３Ｂは、図１に示される外科用器具のＤＬＵの取り付けアセンブリの上部取り付け部分の側方斜視図である。 図３Ｃは、図１に示される外科用器具のＤＬＵの取り付けアセンブリの下部取り付け部分の側方斜視図である。 図３Ｄは、近位本体部分の上からの側方斜視図であり、ツールアセンブリを備えた外科用器具のＤＬＵの取り付けアセンブリおよびツールアセンブリは、その非関節運動位置にある。 図３Ｅは、近位本体部分の上からの側方斜視図であり、ツールアセンブリを備えた図３Ｄに示される取り付けアセンブリおよびツールアセンブリは、その関節運動位置にある。 図３Ｆは、近位本体部分の下からの側方斜視図であり、ツールアセンブリを備えた外科用器具のＤＬＵの取り付けアセンブリおよびツールアセンブリは、その非関節運動位置にある。 図３Ｇは、近位本体部分の下上からの側方斜視図であり、ツールアセンブリを備えた図３Ｆに示される取り付けアセンブリおよびツールアセンブリは、その関節運動位置にある。 図４は、図１Ａに示されるＤＬＵのツールアセンブリの側方断面図である。 図５は、図３に示される近位本体部分ロック機構のロック部材アクチュエーターの上からの斜視図である。 図６は、図３に示される近位本体部分ロック機構のロック部材アクチュエーターの底からの斜視図である。 図７は、そのロック位置にあるロック機構を備えた図１Ａに示されるＤＬＵ近位本体部分の近位端の平面図である。 図８は、図７の断面線８−８に沿ってとった断面図である。 図９は、その非ロック位置にあるロック機構を備えた図１Ａに示されるＤＬＵ近位本体部分の近位端の平面図である。 図１０は、図９の断面線１０−１０に沿ってとった断面図である。 図１１は、ＤＬＵの外科用器具への取り付けの前のＤＬＵおよび図１に示される外科用器具の側方斜視図である。 図１２は、外科用器具の遠位端への取り付け前の図１１に示されるＤＬＵの近位端および外科用器具の遠位端の平面図である。 図１３は、ＤＬＵが外科用器具の遠位端中に直線状に進行されるときの図１１に示されるＤＬＵの近位端の平面図である。 図１４は、ＤＬＵが直線状に進行されるが、ＤＬＵを外科用器具にロックする前の図１２に示されるＤＬＵの近位端および外科用器具の遠位端の平面図である。 図１５は、ＤＬＵが直線状に進行され、そして外科用器具に回転可能にロックされた後の図１３に示されるＤＬＵの近位端および外科用器具の遠位端の平面図である。 図１６は、本開示の実施形態による外科用器具との使用のためのロックアセンブリの斜視図である。 図１７は、図１６のロックアセンブリの種々の構成要素の斜視図である。 図１８は、非関節運動位置にある関節運動ツールアセンブリとともに示される図１６および１７のロックアセンブリの一部分の拡大された斜視図である。 図１９は、図１６〜１８のロックアセンブリの、そしてリンクを含む一部分の拡大された斜視図である。 図２０は、関節運動位置にある関節運動するツールアセンブリとともに示される図１６〜１９のロックアセンブリの一部分の拡大された斜視図である。 図２１は、本開示の実施形態による外科用器具との使用のための別のロックアセンブリの拡大された斜視図である。 図２２は、図２１のロックアセンブリの拡大された底からの斜視図である。 図２３は、本開示の実施形態による、複数の層を有する駆動ビームおよび閉鎖装置の斜視図である。 図２４は、パーツを分離した、図２３の駆動ビームおよび閉鎖装置の斜視図である。 図２５は、図２３および２４の駆動ビームおよび閉鎖装置の断面図である。 図２６は、本開示の実施形態による駆動ビームおよび閉鎖装置の断面図である。 図２７は、図２６の駆動ビームおよび閉鎖装置の断面図である。 図２８は、本開示の実施形態によるツールアセンブリの斜視図である。 図２９は、図２８のツールアセンブリの組み立て図である。
符号の説明
７ ツールアセンブリ
１６ 使い捨て可能な装填ユニット（ＤＬＵ）
１７ ツールアセンブリ
１８ カートリッジアセンブリ
２０ アンビルアセンブリ
２８ アンビル部分
３０ ステープル変形窪み
３２ カバープレート
３４ 窪み
５４ ステープルカートリッジ
５６ 支持チャンネル
５８ タブ
６０ スロット
２００ 近位本体部分
２０２、２３５ 取り付けアセンブリ
２３６ｂ 窪み
２４６、２４７カップリング部材
２４６ｃ、２４７ｃ スプリングアーム
５００ 遠位端
５１０ ハンドル部分
５１２ 本体部分
５１４ 静止ハンドル
５１６ 移動可能ハンドル
５２０ 制御ロッド

Claims (22)

  1. ハンドル部分と、
    該ハンドル部分から遠位側に延び、第１の長手方向軸を定義する本体部分と、
    第２の長手方向軸を定義し、その中に少なくとも１つの窪みを含む関節運動ツールアセンブリであって、該本体部分の遠位端に配置され、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から、少なくとも該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
    少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動させるまで離脱可能に保持する少なくとも１つのカップリング部材とを備える、外科用器具。
  2. 前記関節運動ツールアセンブリの近位端が、取り付けアセンブリを含む、請求項１に記載の外科用器具。
  3. 前記窪みが、前記取り付けアセンブリの一部分中に形成される、請求項２に記載の外科用器具。
  4. 前記取り付けアセンブリの一部分が、前記本体部分の遠位端に旋回可能に固定され、前記関節運動ツールアセンブリの一部分に固定して取り付けられる、請求項２に記載の外科用器具。
  5. 前記第１の長手方向軸に垂直な軸の周りの前記取り付けアセンブリの一部分の旋回移動が、前記関節運動ツールアセンブリを前記第１の位置と前記第２の位置との間で移動させる、請求項２に記載の外科用器具。
  6. 前記カップリング部材の一部分が前記本体部分の一部分に固定可能であり、そして該カップリング部材の少なくとも一部分が、前記取り付けアセンブリの少なくとも一部分に旋回可能に固定可能である、請求項２に記載の外科用器具。
  7. 前記取り付けアセンブリが、上部取り付け部分および下部取り付け部分を含む、請求項２に記載の外科用器具。
  8. 前記少なくと１つのカップリング部材が第１のカップリング部材および第２のカップリング部材を含み、各カップリング部材が前記関節運動ツールアセンブリの少なくとも一部分および前記本体部分の少なくとも一部分との機械的協動に配置される、請求項１に記載の外科用器具。
  9. 前記関節運動ツールアセンブリの近位端上に支持される取り付けアセンブリをさらに含み、該取り付けアセンブリが上部取り付け部分および下部取り付け部分を含み、前記第１のカップリング部材が該上部取り付け部分の少なくとも一部分との機械的協動に配置され、前記第２のカップリング部材が該下部取り付け部分の少なくとも一部分との機械的協動に配置される、請求項８に記載の外科用器具。
  10. 前記第１のカップリング部材の近位端が前記本体部分の遠位端に固定され、該第１のカップリング部材の遠位端が前記上部取り付け部分に旋回可能に固定され、前記第２のカップリング部材の近位端が該本体部部分の遠位端に固定され、該第２のカップリング部材の遠位端が前記下部取り付け部分の近位端に旋回可能に固定される、請求項９に記載の外科用器具。
  11. 前記関節運動ツールアセンブリが、該スプリングアームの一部分が前記窪み内に少なくとも部分的にあるとき第１の位置に離脱可能に保持され、該関節運動ツールアセンブリが、該スプリングアームが該窪みから係合を解かれるとき第２の位置にある、請求項１に記載の外科用器具。
  12. 所定量の力が、前記スプリングアームを前記窪みから解放する、請求項１１に記載の外科用器具。
  13. 前記関節運動ツールアセンブリが、使い捨て可能な装填ユニットの一部分である、請求項１に記載の外科用器具。
  14. 前記関節運動ツールアセンブリが、カートリッジアセンブリおよびアンビルアセンブリを含む、請求項１に記載の外科用器具。
  15. 前記本体部分がハウジング部分を収容するスリーブを含み、該本体部分が該ハウジング部分上に形成される突出部の少なくとも一部分を受容するような寸法である切り抜きを含む、請求項１に記載の外科用器具。
  16. 前記突出部を前記切り抜き内に少なくとも部分的に位置決めすることが、前記スリーブ内の前記ハウジング部分の実質的な軸方向の移動および回転移動を防ぐ、請求項１５に記載の外科用器具。
  17. 移動可能ハンドルを含むハンドル部分であって、作動ストロークを通って移動可能であるハンドル部分と、
    該ハンドル部分から遠位側に延び、第１の長手方向軸を定義する本体部部分と、
    該本体部分の遠位端との離脱可能な係合のための形態である使い捨て可能な装填ユニットとを備え、該使い捨て可能な装填ユニットは、
    近位本体部分と、
    その中に窪みを有し、第２の長手方向軸を定義する関節運動ツールアセンブリであって、該近位本体部分の遠位端に隣接して配置され、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
    少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動するまで離脱可能に保持する少なくとも１つのカップリング部材とを含む、
    外科用ステープル留めデバイス。
  18. 前記関節運動ツールアセンブリの近位端が、取り付けアセンブリを含み、前記窪みが、該取り付けアセンブリの一部分中に形成される、請求項１７に記載の外科用ステープル留めデバイス。
  19. 第１のカップリング部材および第２のカップリング部材を含み、前記取り付けアセンブリが、下部取り付け部分に旋回可能に固定された上部取り付け部分を含み、該第１のカップリング部材が該上部取り付け部分の一部分に旋回可能に固定され、該第２のカップリング部材が該下部取り付け部分の一部分に旋回可能に取り付けられる、請求項１８に記載の外科用ステープル留めデバイス。
  20. 外科用器具との離脱可能な係合のための形態の使い捨て可能な装填ユニットであって、
    第１の長手方向軸を定義する本体部分と、
    該本体部分の遠位側に配置され、その中に窪みを有し、該本体部分の遠位端に固定され、そして第２の長手方向軸を定義する関節運動ツールアセンブリであって、該第２の長手方向軸が該第１の長手方向軸と実質的に整列される第１の位置から該第２の長手方向軸が該第１の長手方向軸と角度をなして配置される第２の位置まで移動可能である関節運動ツールアセンブリと、
    少なくとも１つのスプリングアームを有し、該本体部分の一部分に固定可能である少なくとも１つのカップリング部材であって、該スプリングアームの少なくとも一部分が該関節運動ツールアセンブリの窪み中に受容可能であり、該関節運動ツールアセンブリを該第１の位置に、該少なくとも１つのスプリングアームを外方に曲げるに十分な所定の力が該ツールアセンブリに付与され、該ツールアセンブリを関節運動させるまで離脱可能に保持する少なくとも１つのカップリング部材とを備える、使い捨て可能な装填ユニット。
  21. 前記関節運動ツールアセンブリは、前記スプリングアームの一部分が前記窪み内に少なくとも部分的にあるとき第１の位置にあり、該関節運動ツールアセンブリは、該スプリングアームが該窪みから離れるとき第２の位置にある、請求項２０に記載の使い捨て可能な装填ユニット。
  22. 所定量の力の付与が、前記スプリングアームを前記窪みから解放する、請求項２１に記載の使い捨て可能な装填ユニット。
JP2007260421A 2006-10-06 2007-10-03 関節運動ツールアセンブリを備えた外科用器具 Withdrawn JP2008093434A (ja)

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US11/544,519 US8584921B2 (en) 2006-10-06 2006-10-06 Surgical instrument with articulating tool assembly
US11/544,518 US8608043B2 (en) 2006-10-06 2006-10-06 Surgical instrument having a multi-layered drive beam
US11/544,982 US7845535B2 (en) 2006-10-06 2006-10-06 Surgical instrument having a plastic surface
US11/544,479 US20080083807A1 (en) 2006-10-06 2006-10-06 Surgical instrument including a locking assembly

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