JP2009261943A - 顎閉鎖検出システム - Google Patents
顎閉鎖検出システム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
- A61B18/1447—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod wherein sliding surfaces cause opening/closing of the end effectors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/0063—Sealing
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/067—Measuring instruments not otherwise provided for for measuring angles
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Abstract
【解決手段】端部エフェクターアセンブリのための顎角度検出システムであって:第1の顎部材に付随し、そしてコントローラーおよび発電機の1つに連結するように適合された第1の電気的接点;および第2の顎部材およびアクチュエーターの1つに付随し、そして該コントローラーおよび該発電機の1つに連結されるよう適合されたセンサーであって、該第1の顎部材および第2の顎部材がそれらの間に配置された組織の周囲を閉鎖するために移動されるとき、各第2の顎部材および該アクチュエーターの1つの移動に際し、該第1の電気的接点に対して移動するような形態であるセンサーを備える、顎角度検出システム。
【選択図】図1A
Description
本出願は、Nicole McKennaらによる、2008年4月22日に出願された「顎閉鎖検出システム」と題する米国仮出願番号第61/046,882号に基づく優先権の利益を主張しており、この仮出願は本明細書中に参考として援用される。
本開示は、電気外科的手順を実施するための顎閉鎖検出システムに関する。より詳細には、本開示は、組織の周りの顎閉鎖を検出および/または確認する、そして/または組織がそれらの間に係合されるとき互いに対して対向する顎部材の相対角度を検出する顎感知システムに関する。
鉗子は、組織を締め付け、把持し、解剖し、そして/またはクランプ留めするために機械的作用を利用する。電気外科用鉗子は、機械的クランプ留め作用および電気エネルギーの両方を利用し、組織および血管を加熱することにより止血を行う。顎部材を介して組織に印加される電気外科用エネルギーの強度、周波数および持続時間を制御することにより、外科医は、組織を凝固、焼灼および/または封止し得る。
本開示は、鉗子の端部エフェクターアセンブリのための顎閉鎖機構または顎角度検出器に関し、そして第1の顎部材に連結し、そして発電機(またはコントローラー)に連結する第1の電気的接点を含む。第2の顎部材(またはアクチュエーター)に連結し、そして発電機/コントローラーに連結するセンサーが含まれる。このセンサーは、上記第1の顎部材および第2の顎部材がそれらの間に配置された組織の周りを閉鎖するために移動されるとき、第2の顎部材(またはアクチュエーター)の移動に際し、上記第1の電気的接点に対して移動するような形態である。このセンサーの上記第1の電気的接点に対する位置に関する情報は、上記発電機/コントローラーにリレーして戻され、上記第1の顎部材と上記第2の顎部材との間の角度を決定する。この情報は、モニターまたはその他のタイプの視角または音響インジケーターによって使用者に伝えられる。上記第1の電気的接点の上記センサーに対する相対的位置は、バイナリコードで表され得る。
(項目1)端部エフェクターアセンブリのための顎角度検出システムであって:
第1の顎部材に付随し、そしてコントローラーおよび発電機の1つに連結するように適合された第1の電気的接点;および
第2の顎部材およびアクチュエーターの1つに付随し、そして該コントローラーおよび該発電機の1つに連結されるよう適合されたセンサーであって、該第1の顎部材および第2の顎部材がそれらの間に配置された組織の周囲を閉鎖するために移動されるとき、各第2の顎部材および該アクチュエーターの1つの移動に際し、該第1の電気的接点に対して移動するような形態であるセンサーを備え、ここで、該センサーの該第1の電気的接点に対する位置に関する情報が、該コントローラーおよび該発電機の1つにリレーして戻され、該第1の顎部材と該第2の顎部材との間の角度を決定する、顎角度検出システム。
(項目2)上記センサーが、一連の抵抗器を含む、上記項目のいずれか1項に記載の顎角度検出システム。
(項目3)上記センサーが、電圧分割機ネットワークを含む、上記項目のいずれか1項に記載の顎角度検出システム。
(項目4)上記センサーが、顎部材が閾値角度を過ぎて組織の周囲を閉鎖する際に、第2の電気的接点が上記第1の電気的接点に電気的に接触するとき、上記コントローラーおよび上記発電機の1つに信号を戻して伝達するように位置決定される第2の電気的接点を含む、上記項目のいずれか1項に記載の顎角度検出システム。
(項目5)上記第1の電気的接点の上記センサーに対する相対的位置が、バイナリコードで表される、上記項目のいずれか1項に記載の顎角度検出システム。
(項目6)上記センサーが、可変キャパシターを含む、上記項目のいずれか1項に記載の顎角度検出システム。
(項目7)上記可変キャパシターが、第1の伝導性リングおよび第2の伝導性リングを含み、該第1の伝導性リングが該第2の伝導性リングに対して固定されている、上記項目のいずれか1項に記載の顎角度検出システム。
(項目8)顎角度検出方法であって:
端部エフェクターアセンブリの第1の顎部材の第2の顎部材に対する位置を感知する工程;
感知された位置を表す信号をコントローラーおよび発電機の1つに戻して伝導する工程;
該信号に基づき該第1の顎部材と該第2の顎部材との間の角度を決定する工程;および
決定された角度に基づき、該顎部材へのエネルギー送達を改変する工程、を包含する、顎角度検出方法。
(項目9)上記決定された角度に基づき使用者に情報を提供する工程をさらに包含し、該情報が、組織厚み、上記顎部材の閉鎖の率、封止品質、および再把持状態からなる群から選択される、上記項目のいずれか1項に記載の顎角度検出方法。
図1A〜6を参照して、顎閉鎖検出器または感知機構の種々の実施形態が、本開示に従って開示される。腹腔鏡、内視鏡、または開放器具がこの顎閉鎖検出アセンブリを支持するために利用され得る;しかし、異なる電気的連結および機械的連結ならびに考慮が、各々の特定タイプの器具に適用される。さらに、以下の説明は、電気外科用デバイスと組み合わせた顎閉鎖検出システムに関するけれども、本発明の原理はまた、超音波器具のような開き、かつ閉じる顎を有する任意の適切なタイプの器具と組み合わせて用いられ得る。以下の図面中および説明中で、用語「近位」は、伝統的であるように、使用者により近い鉗子の端部をいい、その一方、用語「遠位」は、使用者からより遠い鉗子の端部をいう。
端部エフェクターアセンブリのための顎角度検出システムは、第1の顎部材に連結し、そして発電機に連結する第1の電気的接点を含む。センサーは、第2の顎部材(またはアクチュエーター)に連結し、そして発電機に連結し、そして上記第1の顎部材および第2の顎部材がそれらの間に配置された組織の周りを閉鎖するために移動されるとき、第2の顎部材(または上記アクチュエーター)の移動に際し、上記第1の電気的接点に対して移動するような形態である。上記センサーの上記第1の電気的接点に対する位置に関する情報は、上記発電機にリレーして戻され、上記第1の顎部材と上記第2の顎部材との間の角度を決定する。
12 シャフト
14 遠位端
30、40a〜40c センサー
60 スリーブ
61 スリーブの遠位端
75a、75b 配線
100 電極封止アセンブリ、端部エフェクターアセンブリ
103 旋回ピン
110、120 顎部材
112、122 封止表面
501 電気外科用発電機
502 独立コントローラー
α 顎角度
Claims (9)
- 端部エフェクターアセンブリのための顎角度検出システムであって:
第1の顎部材に付随し、そしてコントローラーおよび発電機の1つに連結するように適合された第1の電気的接点;および
第2の顎部材およびアクチュエーターの1つに付随し、そして該コントローラーおよび該発電機の1つに連結されるよう適合されたセンサーであって、該第1の顎部材および第2の顎部材がそれらの間に配置された組織の周囲を閉鎖するために移動されるとき、各第2の顎部材および該アクチュエーターの1つの移動に際し、該第1の電気的接点に対して移動するような形態であるセンサーを備え、ここで、該センサーの該第1の電気的接点に対する位置に関する情報が、該コントローラーおよび該発電機の1つにリレーして戻され、該第1の顎部材と該第2の顎部材との間の角度を決定する、顎角度検出システム。 - 前記センサーが、一連の抵抗器を含む、請求項1に記載の顎角度検出システム。
- 前記センサーが、電圧分割機ネットワークを含む、請求項2に記載の顎角度検出システム。
- 前記センサーが、顎部材が閾値角度を過ぎて組織の周囲を閉鎖する際に、第2の電気的接点が前記第1の電気的接点に電気的に接触するとき、前記コントローラーおよび前記発電機の1つに信号を戻して伝達するように位置決定される第2の電気的接点を含む、請求項1に記載の顎角度検出システム。
- 前記第1の電気的接点の前記センサーに対する相対的位置が、バイナリコードで表される、請求項2に記載の顎角度検出システム。
- 前記センサーが、可変キャパシターを含む、請求項1に記載の顎角度検出システム。
- 前記可変キャパシターが、第1の伝導性リングおよび第2の伝導性リングを含み、該第1の伝導性リングが該第2の伝導性リングに対して固定されている、請求項6に記載の顎角度検出システム。
- 顎角度検出方法であって:
端部エフェクターアセンブリの第1の顎部材の第2の顎部材に対する位置を感知する工程;
感知された位置を表す信号をコントローラーおよび発電機の1つに戻して伝導する工程;
該信号に基づき該第1の顎部材と該第2の顎部材との間の角度を決定する工程;および
決定された角度に基づき、該顎部材へのエネルギー送達を改変する工程、を包含する、顎角度検出方法。 - 前記決定された角度に基づき使用者に情報を提供する工程をさらに包含し、該情報が、組織厚み、前記顎部材の閉鎖の率、封止品質、および再把持状態からなる群から選択される、請求項8に記載の顎角度検出方法。
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US4688208P | 2008-04-22 | 2008-04-22 | |
US12/419,735 US8357158B2 (en) | 2008-04-22 | 2009-04-07 | Jaw closure detection system |
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JP2009261943A true JP2009261943A (ja) | 2009-11-12 |
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US (5) | US8357158B2 (ja) |
EP (1) | EP2111813B1 (ja) |
JP (1) | JP2009261943A (ja) |
AU (1) | AU2009201567B2 (ja) |
CA (1) | CA2664199A1 (ja) |
Cited By (4)
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JP2016537129A (ja) * | 2013-11-21 | 2016-12-01 | エシコン・エンド−サージェリィ・エルエルシーEthicon Endo−Surgery, LLC | 電気手術特徴を有する超音波外科用器具 |
JP2018519914A (ja) * | 2015-06-30 | 2018-07-26 | エシコン エルエルシーEthicon LLC | 組織の種類に基づくユーザーが適合可能な技法を有する外科用システム |
JP2019535447A (ja) * | 2016-11-29 | 2019-12-12 | エシコン エルエルシーEthicon LLC | エンドエフェクタの制御及び較正システム |
JP2020175195A (ja) * | 2019-04-18 | 2020-10-29 | バイオセンス・ウエブスター・(イスラエル)・リミテッドBiosense Webster (Israel), Ltd. | 凝固を伴う把持具ツール |
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DE10045375A1 (de) * | 2000-09-14 | 2002-04-11 | Aesculap Ag & Co Kg | Medizinisches Instrument |
JP2005218749A (ja) * | 2004-02-09 | 2005-08-18 | Olympus Corp | 処置装置 |
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JP2016537129A (ja) * | 2013-11-21 | 2016-12-01 | エシコン・エンド−サージェリィ・エルエルシーEthicon Endo−Surgery, LLC | 電気手術特徴を有する超音波外科用器具 |
US11432868B2 (en) | 2013-11-21 | 2022-09-06 | Cilag Gmbh International | Ultrasonic surgical instrument with electrosurgical feature |
JP2018519914A (ja) * | 2015-06-30 | 2018-07-26 | エシコン エルエルシーEthicon LLC | 組織の種類に基づくユーザーが適合可能な技法を有する外科用システム |
JP2019535447A (ja) * | 2016-11-29 | 2019-12-12 | エシコン エルエルシーEthicon LLC | エンドエフェクタの制御及び較正システム |
JP7210447B2 (ja) | 2016-11-29 | 2023-01-23 | エシコン エルエルシー | エンドエフェクタの制御及び較正システム |
JP2020175195A (ja) * | 2019-04-18 | 2020-10-29 | バイオセンス・ウエブスター・(イスラエル)・リミテッドBiosense Webster (Israel), Ltd. | 凝固を伴う把持具ツール |
JP7471897B2 (ja) | 2019-04-18 | 2024-04-22 | バイオセンス・ウエブスター・(イスラエル)・リミテッド | 凝固を伴う把持具ツール |
Also Published As
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US20140288549A1 (en) | 2014-09-25 |
US20130123780A1 (en) | 2013-05-16 |
US9474570B2 (en) | 2016-10-25 |
CA2664199A1 (en) | 2009-10-22 |
EP2111813B1 (en) | 2014-06-11 |
US10245104B2 (en) | 2019-04-02 |
US20170035494A1 (en) | 2017-02-09 |
US20090261804A1 (en) | 2009-10-22 |
US11497547B2 (en) | 2022-11-15 |
EP2111813A1 (en) | 2009-10-28 |
AU2009201567A1 (en) | 2009-11-05 |
AU2009201567B2 (en) | 2013-09-19 |
US8357158B2 (en) | 2013-01-22 |
US20190223942A1 (en) | 2019-07-25 |
US8764749B2 (en) | 2014-07-01 |
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