JP2008212693A - 超音波手術器具 - Google Patents
超音波手術器具 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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in 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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
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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
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00026—Conductivity or impedance, e.g. of tissue
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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
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
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Abstract
【解決手段】ハンドルアセンブリ18、本体20および末端エフェクタ22を備え、本体は、遠位方向に延びてハンドルアセンブリを形成し、末端エフェクタは、組織の切断、切開、凝固および/または結紮を行うように構成される。末端エフェクタ22は、超音波部材26を備える。変換器は、この超音波部材26に隣接して、超音波部材26上または超音波部材26内に支持され、そして電源に接続される。この電源を作動する際に、変換器は、超音波部材26の振動をもたらす。
【選択図】図1−1
Description
本開示は、概して超音波手術器具に関する。より詳細には、本開示は、組織の切開、切断、凝固、結紮および/または止血を行うように構成された末端エフェクタを有し、そしてこの器具内に組み込まれた超小型機械式システム(「MEMS」)を有する超音波手術器具に関し、この器具は、開放外科処置および腹腔鏡手術手順または内視鏡手術手順において使用され得る。
外科的用途のための超音波器具は、周知であり、そして切開、切断、結紮、組織における凝固および/または止血を行うための種々の外科処置において使用される。代表的には、超音波手術器具は、この器具を握るためのハンドピース、このハンドピースの近位端に装着された変換器、およびこの変換器から器具の本体を通って器具の末端エフェクタまで延びる振動結合器を備える。この変換器は、超音波振動数範囲の振動を生成し、この振動は、器具のハンドピースから振動結合器を介して末端エフェクタへと伝送される。この構成は、いくつかの適用において有効であるが、いくつかの欠点を有する。例えば、器具の出力は、超音波エネルギーがデバイスの近位端からデバイスの遠位端に伝送される際に減衰する。さらに、出力損失は、器具の結合およびシールにおいて増大する。公知の手術器具を扱うために、それ自体が大きくて重い変換器が必要とされる。さらに、振動結合器と器具の静止部品との間の接触は、器具に機械的な欠陥を生じる。最後に、振動結合器は、器具の遠位端から器具の近位端へと体液を引き込むポンプとして作用し、それにより使用後の器具の滅菌を困難にする。
超音波手術システムが提供され、このシステムは、変換器を備えた末端エフェクタ、制御モジュール、および手術器具を制御モジュールに相互接続する伝導性ケーブルを有する手術器具を含む。この制御モジュールは、電源(電気出力、a/cジェネレータ、またはバッテリーパックなどを備え得る)に接続されるように適合され、そして器具の末端エフェクタ上に位置する変換器を、超音波振動数または多重超音波振動数で独立してまたは同時に駆動するための制御回路を備える。あるいは、この制御回路は、電源中に組み込まれ得る。超音波器具は、ハンドルアセンブリ、本体部分および一体型または取り外し可能な末端エフェクタを備え、この末端エフェクタは、組織の切断、切開、結紮、止血および/または凝固を行うように構成される。この末端エフェクタは、超音波部材を備え、これは、好ましくはケイ素複合材(例えば、ケイ素−チタン複合材料)から形成される。変換器は、この末端エフェクタの超音波部材上、超音波部材内または超音波部材に隣接して支持される。この超音波部材は、種々の異なる構成を有し得、これらとしては、種々のフック形態、矩形、円形、四角形などが挙げられる。末端エフェクタはまた、クランプ部材またはシヤープローブを備え得る。1つの好ましい実施形態において、器具の内視鏡本体部分は、その長手軸の周りに回転可能であり、内視鏡本体部分の長手軸の周りで末端エフェクタを回転させる。あるいは、末端エフェクタまたは超音波部材は、器具の内視鏡本体部分と独立して回転可能であり得る。
(項目1)
手術器具であって、以下:
ハンドル;
上記ハンドルから遠位方向に延びる細長本体部分であって、上記細長本体は、カニューレまたは本体オリフィスを通過するように寸法決めされかつ構成される、細長本体部分;
上記細長本体部分の遠位端上に支持される末端エフェクタであって、上記末端エフェクタは、変換器および共振部材を有する超音波部材を備え、上記共振部材は、上記変換器に作動可能に接続されており、そして組織の切開、切断、凝固、結紮および/または止血を行うように構成される操作表面を備える、末端エフェクタ、
を備える、手術器具。
(項目2)
項目1に記載の手術器具であって、上記末端エフェクタは旋回可能なクランプを備え、上記旋回可能なクランプは、上記共振部材の操作表面から間隔を空けられた開位置と、上記共振部材の操作表面と並列した配置の閉位置との間で、上記超音波部材の共振部材に対して移動可能である、手術器具。
(項目3)
上記超音波部材が、Jフック形態を有する、項目1に記載の手術器具。
(項目4)
上記超音波部材が、Lフック形態を有する、項目1に記載の手術器具。
(項目5)
上記超音波部材が、矩形形態を有する、項目1に記載の手術器具。
(項目6)
上記超音波部材が、へら状形態を有する、項目1に記載の手術器具。
(項目7)
上記変換器が、ケイ素プレートの周りに位置付けられる複数のPZT結晶を備える、項目1に記載の手術器具。
(項目8)
上記共振部材が、ケイ素/金属複合材から形成される、項目7に記載の手術器具。
(項目9)
項目1に記載の手術器具であって、上記細長本体部分の遠位端に旋回可能に装着された関節結合部材をさらに備え、上記末端エフェクタは、上記関節結合部材により支持されており、ここで上記関節結合部材は、上記末端エフェクタの関節結合を行うために旋回可能である、手術器具。
(項目10)
手術される組織の状態をモニタリングするために、上記超音波部材上に位置付けられたセンサをさらに備える、項目1に記載の手術器具。
(項目11)
上記状態が温度である、項目10に記載の手術器具。
(項目12)
上記状態が、超音波または電気インピーダンスである、項目10に記載の手術器具。
(項目13)
超音波手術システムであって、以下:
内視鏡超音波器具であって、ハンドル、細長本体部分および末端エフェクタを備え、上記末端エフェクタは、変換器を有する超音波部材を備え、そして上記細長本体部分は、カニューレまたは本体オリフィスを通して挿入可能であるように寸法決めされかつ構成される、内視鏡超音波器具;
電源に係合するように適合された制御モジュールであって、上記制御モジュールは、上記変換器を1以上の超音波振動数で駆動するための電子制御回路を備える、制御モジュール;および
上記制御モジュールおよび上記超音波器具を相互接続する、電気ケーブル、
を備える、超音波手術システム。
(項目14)
項目13に記載の超音波手術システムであって、上記超音波器具内に位置付けられた導体をさらに備え、上記導体は、上記変換器と連絡している遠位端および上記電気ケーブルに係合するように適合された近位端を有する、超音波手術システム。
(項目15)
上記導体が、同軸ケーブルを備える、項目14に記載の超音波手術システム。
(項目16)
項目15に記載の超音波手術システムであって、手術される組織の特性を感知するために、上記超音波部材上に位置付けられたセンサをさらに備え、ここで上記制御モジュールが、上記センサと相互作用して上記超音波器具の操作を制御するフィードバック回路を備える、超音波手術システム。
(項目17)
上記末端エフェクタが、関節結合のために上記手術器具上に支持される、項目13に記載の超音波手術システム。
(項目18)
項目13に記載の超音波手術システムであって、ここで上記超音波部材は、フレーム、共振構造および上記変換器を備え、ここで上記変換器は、上記共振構造と接触して位置付けられ、そして上記共振構造は、組織の切開、切断、結紮および/または凝固を行うための操作表面を備える、超音波手術システム。
本発明に開示された超音波手術器具の好ましい実施形態は、図面を参照して詳細に記載され、この図面において、同様の参照番号は、いくつかの図面の各々において同じかまたは対応する要素を示す。
12 超音波器具
13 回転ノブ
14 制御モジュール
15 電源コード
16 伝導ケーブル
18 ハンドルアセンブリ
20 細長本体
22 末端エフェクタ
24 旋回クランプ部材
26 超音波部材
Claims (11)
- 手術器具であって、以下:
ハンドル;
該ハンドルから遠位方向に延びる細長本体部分であって、該細長本体は、カニューレまたは本体オリフィスを通過するように寸法決めされかつ構成される、細長本体部分;および
該細長本体部分の遠位端上に支持される末端エフェクタであって、該末端エフェクタは、変換器および共振部材を有する超音波部材を備え、該共振部材は、該変換器に作動可能に接続されており、そして組織の切開、切断、凝固、結紮および/または止血を行うように構成される操作表面を備える、末端エフェクタ、を備え、
該手術器具が、該細長本体部分の遠位端に旋回可能に装着された関節結合部材をさらに備え、該末端エフェクタが、該関節結合部材により支持されており、ここで該関節結合部材が、該末端エフェクタの関節結合を行うために旋回可能である、手術器具。 - 請求項1に記載の手術器具であって、前記末端エフェクタは旋回可能なクランプを備え、該旋回可能なクランプは、前記共振部材の操作表面から間隔を空けられた開位置と、該共振部材の操作表面と並列した配置の閉位置との間で、前記超音波部材の共振部材に対して移動可能である、手術器具。
- 前記超音波部材が、Jフック形態を有する、請求項1に記載の手術器具。
- 前記超音波部材が、Lフック形態を有する、請求項1に記載の手術器具。
- 前記超音波部材が、矩形形態を有する、請求項1に記載の手術器具。
- 前記超音波部材が、へら状形態を有する、請求項1に記載の手術器具。
- 前記変換器が、ケイ素プレートの周りに位置付けられる複数のPZT結晶を備える、請求項1に記載の手術器具。
- 前記共振部材が、ケイ素/金属複合材から形成される、請求項7に記載の手術器具。
- 手術される組織の状態をモニタリングするために、前記超音波部材上に位置付けられたセンサをさらに備える、請求項1に記載の手術器具。
- 前記状態が温度である、請求項9に記載の手術器具。
- 前記状態が、超音波または電気インピーダンスである、請求項9に記載の手術器具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US26725101P | 2001-02-08 | 2001-02-08 | |
US60/267,251 | 2001-02-08 |
Related Parent Applications (1)
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JP2002562250A Division JP4152188B2 (ja) | 2001-02-08 | 2002-02-08 | 超音波手術器具 |
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JP2011178631A Division JP2012005851A (ja) | 2001-02-08 | 2011-08-17 | 超音波手術器具 |
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JP2008212693A true JP2008212693A (ja) | 2008-09-18 |
JP4896056B2 JP4896056B2 (ja) | 2012-03-14 |
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JP2002562250A Expired - Fee Related JP4152188B2 (ja) | 2001-02-08 | 2002-02-08 | 超音波手術器具 |
JP2008079368A Expired - Fee Related JP4896056B2 (ja) | 2001-02-08 | 2008-03-25 | 超音波手術器具 |
JP2011178631A Pending JP2012005851A (ja) | 2001-02-08 | 2011-08-17 | 超音波手術器具 |
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JP2002562250A Expired - Fee Related JP4152188B2 (ja) | 2001-02-08 | 2002-02-08 | 超音波手術器具 |
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JP2011178631A Pending JP2012005851A (ja) | 2001-02-08 | 2011-08-17 | 超音波手術器具 |
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US (1) | US10022142B2 (ja) |
EP (3) | EP2000106B1 (ja) |
JP (3) | JP4152188B2 (ja) |
AU (2) | AU2002244082B2 (ja) |
CA (1) | CA2437582C (ja) |
DE (2) | DE60236701D1 (ja) |
ES (3) | ES2317994T3 (ja) |
WO (1) | WO2002062241A1 (ja) |
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2010047395A1 (ja) * | 2008-10-23 | 2010-04-29 | オリンパスメディカルシステムズ株式会社 | 超音波処置具と超音波手術システム |
JP4642935B2 (ja) * | 2008-10-23 | 2011-03-02 | オリンパスメディカルシステムズ株式会社 | 超音波処置具と超音波手術システム |
CN102176874A (zh) * | 2008-10-23 | 2011-09-07 | 奥林巴斯医疗株式会社 | 超声波处理器具和超声波手术系统 |
JPWO2010047395A1 (ja) * | 2008-10-23 | 2012-03-22 | オリンパスメディカルシステムズ株式会社 | 超音波処置具と超音波手術システム |
JP2017508575A (ja) * | 2014-02-17 | 2017-03-30 | オックスフォード ユニバーシティ イノベーション リミテッドOxford University Innovation Limited | ステント留置装置 |
US10548751B2 (en) | 2014-02-17 | 2020-02-04 | Oxford University Innovation Limited | Stent placement device |
Also Published As
Publication number | Publication date |
---|---|
CA2437582C (en) | 2009-09-15 |
ES2346720T3 (es) | 2010-10-19 |
AU2006220448A1 (en) | 2006-10-19 |
JP2004522523A (ja) | 2004-07-29 |
JP4152188B2 (ja) | 2008-09-17 |
CA2437582A1 (en) | 2002-08-15 |
ES2373782T3 (es) | 2012-02-08 |
DE60236701D1 (de) | 2010-07-22 |
JP2012005851A (ja) | 2012-01-12 |
DE60230533D1 (de) | 2009-02-05 |
EP2221011A2 (en) | 2010-08-25 |
EP1435852A1 (en) | 2004-07-14 |
EP2221011B8 (en) | 2012-02-29 |
EP2221011B1 (en) | 2011-09-21 |
JP4896056B2 (ja) | 2012-03-14 |
ES2317994T3 (es) | 2009-05-01 |
EP2221011A3 (en) | 2010-09-08 |
US20160113672A1 (en) | 2016-04-28 |
EP2000106B1 (en) | 2010-06-09 |
EP2000106A1 (en) | 2008-12-10 |
WO2002062241A1 (en) | 2002-08-15 |
AU2006220448B2 (en) | 2009-06-04 |
EP1435852B1 (en) | 2008-12-24 |
AU2002244082B2 (en) | 2006-06-22 |
US10022142B2 (en) | 2018-07-17 |
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