JP2008504050A - 外科用手接近装置 - Google Patents
外科用手接近装置 Download PDFInfo
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- JP2008504050A JP2008504050A JP2007506367A JP2007506367A JP2008504050A JP 2008504050 A JP2008504050 A JP 2008504050A JP 2007506367 A JP2007506367 A JP 2007506367A JP 2007506367 A JP2007506367 A JP 2007506367A JP 2008504050 A JP2008504050 A JP 2008504050A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/313—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for introducing through surgical openings, e.g. laparoscopes
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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
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3498—Valves therefor, e.g. flapper valves, slide valves
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00265—Hand assisted surgery, i.e. minimally invasive surgery with at least part of an assisting hand inside the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3482—Means for supporting the trocar against the body or retaining the trocar inside the body inside
- A61B2017/3484—Anchoring means, e.g. spreading-out umbrella-like structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/348—Means for supporting the trocar against the body or retaining the trocar inside the body
- A61B2017/3492—Means for supporting the trocar against the body or retaining the trocar inside the body against the outside of the body
Abstract
Description
本願は、2004年4月5日出願の仮出願番号第60/559,678号への利益を主張する。この出願の内容は、本明細書中に参考として援用される。
(1.開示の分野)
本開示は、全体として、身体壁を横切り、そして体腔中へのシールされた接近を容易にするための外科用デバイスに関し、そしてより具体的には、切開部の選択的な退却を提供して腹腔鏡外科手順および内視鏡外科手順の間の外科医の手および/または外科用器具のいずれかのシールされた挿入を可能にするように適合可能な外科用接近装置に関する。
内視鏡手順および腹腔鏡手順の両方を含む最少侵襲外科手順は、外科手術が、器官、組織および組織内で開口部から遠く離れた血管で実施されることを可能にする。腹腔鏡手順および内視鏡手順は、一般に、身体に挿入されるあらゆる器具がシールされていることを必要とする。すなわち、外科手術領域がガス注入されているとき、例えば、外科手術領域がガス注入されている外科手順において、切開部を通って気体が身体に出入りしないことを確実にするために準備がなされねばならない。これらの手順は、代表的には、カニューレを通して身体中に導入される外科用器具を採用する。カニューレは、それらと連携するシールアセンブリを有する。このシールアセンブリは、器具のまわりで実質的な流体密なシールを提供して、確立された腹腔気体造影法の一体性を保存する。
従って、本開示は、腹腔鏡外科手順および内視鏡外科手順の間の外科医の手および/または外科用器具のいずれかのシールされた挿入を可能にするように適合可能な外科用接近装置に関する。1つの好ましい実施形態では、外科用接近装置は、組織本体内の開口部を通る挿入のために適合された内側部材であって、この本体内に位置決めするためのものである、内側部材;この内側部材から延びる少なくとも1つの張力付与要素、およびこの本体の外部に位置決めするための外側部材を備える。この外側部材は、第1の要素および第2の要素を備える。この第2の要素は、この少なくとも1つの張力付与要素に作動可能に連結され、そしてこの本体内の開口部を規定する組織の退却を引き起こすための、この第1の部材に対する回転運動のために適合されている。この少なくとも1つの張力付与要素は、好ましくは上記内側部材に連結されており、上記第2の要素の回転の際に、内側部材を外側部材に向かって変位させるように適合されている。
本開示の外科用接近装置は、この装置を通る物体の挿入の前、挿入の間、および挿入後の患者の体腔と外部の大気との間の実質的なシールを提供する。さらに、本発明の接近装置は、切開部内での位置決めのために適合されており、その切開部を規定する組織を選択的に退却させてその下に存在する組織への接近を可能にし得る。この接近装置は、手に支援される腹腔鏡手順の間、外科医の手および/または腕を収容し、そして挿入されたときの腕との気密なシールを確立するように特に適合されている。しかし、この接近装置は、外科手術用器具のような他の物体を受容するように適合され得る。この接近装置は、その物体がないときには実質的に閉鎖してガス注入された腸腔の一体性を維持するようにさらに適合されている。
手で支援される腹腔鏡外科手順に関連する接近装置100の使用が考察される。当該分野で慣用的であるように、腸腔がガス注入され、例えば、トロカールを用いて腔内に切開部が作製されて、腔への接近が提供される。その後で、図15〜16に描写されるように、ライナー基部104が切開部内に導入される。具体的には、下部リング170がその切開部を通され、体腔内に配置される。注記されるように、下部リング170は、切開部を通る通過を容易にするために、それ自身の上に狭められ、次いで解放されて腔内で(その固有の弾性の影響の下で)下部リング170がその通常の状態に戻ることを可能にする。ライナースリーブ168は、下部リング170から切開部を通って延び、以前に考察したように、切開部を内張りする。
Claims (21)
- 外科用接近装置であって、
組織本体内の開口部を通る挿入のために適合された内側部材であって、該本体内に位置決めするためのものである、内側部材;
該内側部材から延びる少なくとも1つの張力付与要素;および
該本体の外部に位置決めするための外側部材であって、第1の要素および第2の要素を備え、該第2の要素は、該少なくとも1つの張力付与要素に作動可能に連結され、そして該本体内の開口部を規定する組織の退却を引き起こすための、該第1の部材に対する回転運動のために適合された外側部材、
を備える、外科用接近装置。 - 前記少なくとも1つの張力付与要素が、前記内側部材に連結されている、請求項1に記載の外科用接近装置。
- 前記少なくとも1つの張力付与要素が、前記第2の要素の回転の際に、前記内側部材を前記外側部材に向かって変位させるように適合されている、請求項2に記載の外科用接近装置。
- 複数の張力付与要素を備える、請求項3に記載の外科用接近装置。
- 前記第2の部材が、前記第1の部材に対して回転して前記張力付与要素の有効長を減少するように適合されており、前記内側部材を内側本体の壁と係合するように前記外側部材に向かって変位させて前記開口部を規定する前記組織を退却させる、請求項4に記載の外科用接近装置。
- 前記内側部材に連結され、前記身体組織内の前記開口部を通して該内側部材から延びるような寸法であるライナー部材をさらに備え、該ライナー部材は、物体の通過を可能にするために該ライナー部材を通る通路を開く、請求項1に記載の外科用接近装置。
- 前記張力付与要素が、前記ライナー部材内に包埋されている、請求項6に記載の外科用接近装置。
- 前記張力付与要素が、前記ライナー部材内に対して移動可能である、請求項7に記載の外科用接近装置。
- 前記第2の要素が、前記少なくとも1つの張力付与要素に選択的に張力を与えるために、前記第1の要素に対して所定の角度のついた配向で固定されるように適合されている、請求項2に記載の外科用接近装置。
- 前記第2の要素が、前記第1の部材に対して複数の所定の角度のついた関係で固定されるように適合されている、請求項9に記載の外科用接近装置。
- 前記第1の要素および第2の要素を、複数の相対的な角度のついた関係で選択的に固定するための手段をさらに備える、請求項5に記載の外科用接近装置。
- 前記選択的に固定するための手段が、前記第1の要素および第2の要素と連動するつめ車機構を備える、請求項11に記載の外科用接近装置。
- 前記ライナー部材の通路に対して取り付けられたシールを備え、該シールは、該通路を通って挿入される物体のまわりで流体密のシールを形成するように適合されている、請求項1に記載の外科用接近装置。
- 前記ライナー部材に対して取り付けられたゼロ閉鎖バルブを備え、該ゼロ閉鎖バルブは、該ゼロ閉鎖バルブを通って位置決めされる物体が存在しないときは流体密のシールを形成するように適合されている、請求項13に記載の外科用接近装置。
- 前記ゼロ閉鎖バルブが、ダックビルバルブである、請求項14に記載の外科用接近装置。
- 外科用接近装置であって、
ライナー基部であって、
身体内に位置決めするために、該身体組織内の該開口部を通る挿入のために適合された内側部材;
該内側部材に連結され、かつ該身体組織内の開口部を通って該内側部材から延びるような寸法であるスリーブ部材であって、物体の通過を可能にするために、該スリーブ部材を通る通路を規定する、スリーブ部材;および
該内側部材に連結され、かつ該スリーブ部材と連携する複数の張力付与要素であって、該スリーブ部材に対して張力付与効果をもたらすためのものである、張力付与要素、
を備える、ライナー基部;ならびに
該身体の外側に位置決めするための接近ハウジングであって、該接近ハウジングは、第1の要素および第2の要素を備え、該第2の要素は、該張力付与要素に作動可能に連結され、かつ該第1の部材に対する回転運動のために適合され、該張力付与要素を該接近ハウジングに向かって変位させ、そして該スリーブ部材に該身体内の該開口部を規定する組織と係合しかつ退却させる、接近ハウジング、
を備える、外科用接近装置。 - 前記張力付与部材が、前記第2の要素の回転の際に、前記スリーブ部材に対して移動するように適合されている、請求項16に記載の外科用接近装置。
- 前記張力付与部材が、前記スリーブ部材内に包埋されている、請求項17に記載の外科用接近装置。
- 前記接近ハウジングに取り付けられたシールを備え、該シールは、該接近ハウジングを通って挿入される物体のまわりで流体密なシールを形成する、請求項16に記載の外科用接近装置。
- 前記ライナー部材に対して取り付けられたゼロ閉鎖バルブを備え、該ゼロ閉鎖バルブは、該ゼロ閉鎖バルブを通って配置される物体が存在しないときは流体密のシールを形成するように適合されている、請求項19に記載の外科用接近装置。
- 前記第2の部材が、前記第1の部材に対して所定の回転した関係で選択的に固定されるように適合されている、請求項16に記載の外科用接近装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US55967804P | 2004-04-05 | 2004-04-05 | |
US60/559,678 | 2004-04-05 | ||
PCT/US2005/011555 WO2005097019A2 (en) | 2004-04-05 | 2005-04-05 | Surgical hand access apparatus |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2010263020A Division JP2011062544A (ja) | 2004-04-05 | 2010-11-25 | 外科用手接近装置 |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2008504050A true JP2008504050A (ja) | 2008-02-14 |
JP4868602B2 JP4868602B2 (ja) | 2012-02-01 |
Family
ID=35125593
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2007506367A Expired - Fee Related JP4868602B2 (ja) | 2004-04-05 | 2005-04-05 | 外科用手接近装置 |
JP2010263020A Withdrawn JP2011062544A (ja) | 2004-04-05 | 2010-11-25 | 外科用手接近装置 |
JP2012237664A Withdrawn JP2013017843A (ja) | 2004-04-05 | 2012-10-29 | 外科用手接近装置 |
Family Applications After (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2010263020A Withdrawn JP2011062544A (ja) | 2004-04-05 | 2010-11-25 | 外科用手接近装置 |
JP2012237664A Withdrawn JP2013017843A (ja) | 2004-04-05 | 2012-10-29 | 外科用手接近装置 |
Country Status (6)
Country | Link |
---|---|
US (4) | US7393322B2 (ja) |
EP (2) | EP1737404B1 (ja) |
JP (3) | JP4868602B2 (ja) |
AU (2) | AU2005231485B2 (ja) |
CA (1) | CA2560154C (ja) |
WO (1) | WO2005097019A2 (ja) |
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CN114533215A (zh) * | 2022-02-08 | 2022-05-27 | 浙江天松医疗器械股份有限公司 | 一种多通道单孔穿刺器 |
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US8328844B2 (en) | 2012-12-11 |
JP4868602B2 (ja) | 2012-02-01 |
EP2407091B1 (en) | 2013-08-28 |
EP1737404B1 (en) | 2013-01-16 |
AU2005231485B2 (en) | 2010-08-05 |
WO2005097019A2 (en) | 2005-10-20 |
EP2407091A3 (en) | 2012-02-29 |
US20120136214A1 (en) | 2012-05-31 |
JP2013017843A (ja) | 2013-01-31 |
JP2011062544A (ja) | 2011-03-31 |
US20050222582A1 (en) | 2005-10-06 |
EP1737404A4 (en) | 2009-08-26 |
CA2560154C (en) | 2013-06-25 |
CA2560154A1 (en) | 2005-10-20 |
AU2005231485A1 (en) | 2005-10-20 |
AU2010235943A1 (en) | 2010-11-11 |
US20080249373A1 (en) | 2008-10-09 |
WO2005097019A3 (en) | 2007-12-06 |
US9028402B2 (en) | 2015-05-12 |
EP1737404A2 (en) | 2007-01-03 |
US20130066161A1 (en) | 2013-03-14 |
US7393322B2 (en) | 2008-07-01 |
US8123682B2 (en) | 2012-02-28 |
AU2010235943B2 (en) | 2012-05-10 |
EP2407091A2 (en) | 2012-01-18 |
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