JP2009261943A - 顎閉鎖検出システム - Google Patents

顎閉鎖検出システム Download PDF

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JP2009261943A
JP2009261943A JP2009103484A JP2009103484A JP2009261943A JP 2009261943 A JP2009261943 A JP 2009261943A JP 2009103484 A JP2009103484 A JP 2009103484A JP 2009103484 A JP2009103484 A JP 2009103484A JP 2009261943 A JP2009261943 A JP 2009261943A
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jaw
jaw member
sensor
angle
angle detection
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Nicole Mckenna
マッケナ ニコル
Robert Wham
ワム ロバート
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445Probes 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
    • A61B18/1447Probes 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1442Probes having pivoting end effectors, e.g. forceps
    • A61B18/1445Probes 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/28Surgical forceps
    • A61B17/29Forceps for use in minimally invasive surgery
    • A61B2017/2926Details of heads or jaws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063Sealing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/067Measuring instruments not otherwise provided for for measuring angles

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Abstract

【課題】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を提供すること。
【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

(関連出願への相互参照)
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。
(背景)
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。
(技術分野)
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。
より大きな血管または厚い組織で適正な封止を行うために、2つの支配的な機械的パラメーターが正確に制御されるべきである:組織に付与される圧力;および電極間のギャップである。認識され得るように、これらパラメーターの両方は、血管または組織の厚みによって影響される。より詳細には、圧力の正確な付与がいくつかの理由のために重要である:組織インピーダンスを、組織を通る十分な電気外科用エネルギーを可能にするに十分低く低減するため;組織加熱の間の拡大の力を克服するため;および良好な封止の指標である、組織の厚みを終結するように寄与するため、である。
いくつかの例では、より大きな血管または組織を適正にかつ効率的に封止するために、対向する顎部材間により大きな閉鎖力および顎閉鎖の正確な検出が要求され、そしていくつかの場合には、顎閉鎖の角度が、一貫し、そして信頼性のある封止を確実にするために重要である。これは製造業者に設計課題を呈示する。なぜなら、顎部材は、代表的には、各顎部材の旋回に対して小モーメントのアームを有するように位置決めされるピンで固定され、そしてしばしば正確な顎閉鎖を評価することは困難であるからである。さらに、これら公知の器具の多くは、一般に、適切な封止厚みを獲得するためにクランプ留め圧力のみに依存し、そしてしばしば、適正に制御される場合、一貫し、かつ効率的な組織シールを確実にし得るパラメーターである、ギャップ許容誤差および/または平行度要求および平坦さ要求に関する顎閉鎖変数を考慮して設計されていない。
(要旨)
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。
いくつかの実施形態では、上記センサーは、上記発電機(またはコントローラー)に情報を戻してリレーする可変抵抗器、一連の抵抗器または電圧分割機ネットワーク(ポテンショメーター)を含む。なお別の実施形態では、上記センサーは、第1の伝導性リングおよび第2の伝導性リングを含み得る可変キャパシターを含み、この第1の伝導性リングは、上記第2の伝導性リングに対して固定されている。
別の実施形態では、上記センサーは第2の電気的接点を含み、この第2の電気的接点は、上記顎部材が、特定の角度、例えば、閾値角度を超えて組織の周りを閉鎖する際、上記第2の電気的接点が上記第1の電気的接点に電気的に接続するとき、上記発電機/コントローラーに信号を戻して伝達するように位置決めされる。この閾値角度は、上記顎部材が組織の周りで閉鎖され、一貫し、かつ信頼性ある封止を確実にする角度である。
本開示はまた、第1の顎部材および第2の顎部材、ならびに電気発電機の容量性感知回路に連結するように適合された第1のコンダクターおよび第2のコンダクター(例えば、伝導性リング)を有する顎角度検出器に関する。この第1のコンダクターは、第2のコンダクターに対して固定され、そしてこの第2のコンダクターは、顎部材の互いに対して間隔をおいた第1の位置から、互いにより近い第2の位置までの移動に際し、上記第1のコンダクターに対して移動可能である。第2のコンダクターの第1のコンダクターに対する位置に関する情報は、上記要領性感知回路にリレーして戻され、第1の顎部材と第2の顎部材との間の角度を決定する。実施形態では、上記第2のコンダクターは、内視鏡電気外科用鉗子または一側性内視鏡電気外科用鉗子の移動可能な顎部材の駆動ロッドに取り付けられる。
本開示はまた、顎部材の間に保持された組織を通ってエネルギーを伝達するために電気外科用エネルギー供給源に連結するように適合された近位方向に延びるフランジを各々が有する、第1の顎部材および第2の顎部材を含む顎角度検出器に関する。コンダクターが、第1の顎部材の近位フランジ上に配置され、そして可変抵抗器(例えば、一連の抵抗器、電圧分割機ネットワークなど)が上記コンダクターに対向する関係で上記第2の顎部材の近位フランジ上に配置される。上記第1のコンダクターおよび上記可変抵抗器は、信号を上記電気外科用発電機の感知回路にリレーするよう適合されている。上記顎部材の、開いて間隔が空いた位置から閉じた位置までの移動は、上記コンダクターを上記可変抵抗器を横切って移動するようにし、そして上記感知回路にリレーして戻される信号を変え、これは、次に、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。実施形態では、上記可変抵抗器は、上記第2の顎部材中に規定されるポートに配置され、このポートは、その中に上記コンダクターを機械的に受容するような形態である。
例えば、本発明は以下の項目を提供する。
(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。
本開示の種々の実施形態は、図面を参照して本明細書中に記載される。
図1Aは、本開示による顎閉鎖検出システムの1つの実施形態を支持するような形態の一側性腹腔鏡双極鉗子の側面図である。 図1Bは、本開示による顎閉鎖検出システムの別の実施形態を支持するような形態の開放双極鉗子の端部エフェクターアセンブリの側面図である。 図2は、本開示による顎閉鎖検出システムの1つの実施形態を支持するような形態の開放双極鉗子の端部エフェクターアセンブリの拡大側面図である。 図3は、可変抵抗器を含む本開示による顎閉鎖検出システムの別の実施形態を支持するような形態の二側性内視鏡双極鉗子の側面図である。 図4Aは、組織を把持する前の第1の配向にある顎閉鎖検出システムを示す開放鉗子の端部エフェクターアセンブリの前方からの斜視図である。 図4Bは、閉鎖された顎部材をともなう第2の配向にある顎閉鎖検出システムを示す図4Aの端部エフェクターアセンブリの前方からの斜視図である。 図5は、可変キャパシターを含む、本開示による顎閉鎖検出システムの別の実施形態を支持するような形態の内視鏡鉗子の駆動アクチュエーターの概略図である。 図6は、図5の可変キャパシターとの使用のための容量性感知回路の概略回路図である。
(詳細な説明)
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。
図1Aは、電極封止アセンブリ100を支持するような形態である一側性腹腔鏡血管封止鉗子10を示す。鉗子10は、代表的には、この鉗子10および端部エフェクターアセンブリ100が互いに協同して組織を把持し、封止し、そして正当な理由がある場合、分割するようにする種々の従来の特徴(例えば、ハウジング、ハンドルアセンブリ、回転アセンブリ、トリガーアセンブリ)を含む。鉗子10は、端部エフェクターアセンブリ100を機械的に係合するような寸法の遠位端14、およびハウジング(図示はされていない)を機械的に係合する近位端(図示はされていない)を有する。鉗子10の種々の構成要素の相互協同関係に関する詳細は、本出願人がともに所有する米国特許出願第11/348,072号に開示されている。
鉗子はまた、1つ以上の電気ケーブル(図示はされていない)を経由して、この鉗子10をエネルギーの供給源、例えば、電気外科用発電機501に連結するプラグを含む。その他の電気的接続(図示はされていない)は、シャフト12および端部エフェクターアセンブリ100を通って位置決めされ、顎部材110および120の対向する封止表面112および122に双極電気エネルギーをそれぞれ供給する。これら顎部材110および120は、アクチュエーターまたはハンドル(図示はされていない)の移動に応答して、電気的に伝導性の封止表面112および122が互いに対して間隔を置いた関係で配置される開放位置から、これら電気的に伝導性の封止表面112および122が協同して組織401をそれらの間に把持する(図2を参照のこと)クランプ留めまたは閉鎖位置まで移動する。再び、鉗子10のアクチュエーターまたはハンドルの相互作動する構成要素の相互協同関係に関する詳細は、本出願人がともに所有する米国特許出願第11/348,072号に開示されている。顎部材110および120の電気的に伝導性の封止表面112および122が、組織の周りで完全に圧縮されるとき、鉗子10は、ここで、電気外科用エネルギーの選択的付与の準備が整う。
上記で述べたように、図1Aは、シャフト12に固定された関係で取り付けられる1つの静止または固定された顎部材120、およびこの静止顎部材120に取り付けられた旋回ピン103の周りに取り付けられた旋回顎部材110を有する一側性端部エフェクターアセンブリ100を含む双極鉗子10を示す。往復運動するスリーブ60は、シャフト12内に滑動可能に配置され、そして駆動アクチュエーター(図示はされていない)によって遠隔から作動可能である。旋回する顎部材110は、顎部材110から、往復運動するスリーブ60内に規定されるアパーチャを通って延びる移動止めまたは突出部125を含む。この旋回する顎部材110は、スリーブ60をシャフト12内で、アパーチャの遠位端が旋回する顎部材110上の移動止め125に対して接するように滑動することにより作動される。スリーブ60を近位方向に引くことは、顎部材110および120をそれらの間に把持された組織の周りで閉鎖し、そしてスリーブ60を遠位方向に押すことは、把持する目的のために顎部材110および120を開放する。
1つの実施形態では、顎部材の1つ、例えば、顎部材110は、移動止め125上に配置されたセンサー30を含む。往復運動するスリーブ60は、その遠位端61上に配置された1つ以上の対応するセンサー40a〜40cを含む。これらセンサー30および40a〜40cは、配線75aおよび75bをそれぞれ経由して発電機501または独立コントローラー502に付随するフィードバック回路に電気的に連結され、これは、センサー30のセンサー40a〜40cに対する位置をそれぞれ決定し、そして相対的位置を顎部材110と120との間の顎角度「α」と関連付ける。センサー30およびセンサー40a〜40cは、磁気性、抵抗性、容量性、光学的または任意のその他の適切なタイプのセンサーであり得る。使用において、使用者が駆動スリーブ60を近位方向に作動して顎部材110および120を互いに対して閉鎖するとき、センサー30は、次いで、センサー40a〜40cに対して移動する。フィードバックループは、顎部材110および120の角度「α」を算出し、そして使用者に情報を提供して戻す。
センサー30および40a〜40cはまた、(閉鎖に対する相対的抵抗に基づく)組織厚み、顎閉鎖の率、および顎部材110および120が電気外科用エネルギーの付与のために組織の周りで適切に閉鎖されているか否かに関して使用者にさらなるフィードバックを提供するような形態であり得る。さらに、顎閉鎖角度「α」は、不十分な顎閉鎖に起因する封止の間の「再把持」状態を決定するために用いられ得るか、または、起動の前、その間、またはその後いずれかで、その封止の全体の妥当性を決定するために用いられ得る。別の実施形態では、この顎閉鎖角度「α」は、発電機501からのエネルギー送達を改変するために用いられ得、封止プロセスを促進する。
図2に示されるように、別の実施形態では、単一の電気的接点240が、センサーとして作用し得、顎閉鎖を決定し、そして発電機501に上記顎角度「α」に関する情報を提供する。例えば、図2は、組織を係合するために旋回点265の周りで互いに対して移動可能な2つの対向する顎部材210および220を含む別の鉗子設計200を示す。顎部材210および220は各々、組織を通って双極エネルギーを選択的に伝導するために発電機501に連結するその上に配置された電気的に伝導性の表面212および222をそれぞれ含む。
顎部材220はまた、開放位置から閉鎖位置までの顎部材210および220の移動に際し、末端コネクター250またはいわゆる「POGO」ピンがその中に乗ることを可能にする、その中に規定されたガイドスロット224を有する近位部分またはベース245を含む。顎部材210の対応するベース235は、発電機501または独立コントローラー502に電気的に連結するスロット224の近位に配置されたセンサーまたは接点240を含む。上記で説明されたように、このセンサー240は、顎部材210および220の互いに対する角度「α」に関する1つ以上のフィードバックループを経由して発電機に情報を戻して提供するような形態であり得る。
センサー240はまた、上記で説明されるように、発電機501に戻るさらなる情報を提供するような形態であり得る。1つの実施形態では、センサー240は安全機構として作用し得、ここで、この電気的接点240は、上記2つの対向する顎部材210および220が、電気エネルギーの付与のために一緒に十分近く移動されている(例えば、閾値角度を超えて移動した)か否かを単に決定する。このようにして、顎部材210および220が、所望より小さい、または封止を開始するために適切なより小さい角度に近づくとき、センサー240は、末端コネクター250に電気的に接続されず、信号を発電機501に戻して送り、起動を可能にする。例えば、顎部材210および220が、血管または組織を封止するために適切でない角度で開かれるとき、センサー240は、非伝導性材料に対向して(または対して)位置決めされ得、そして、結果として、信号を発電機501に戻して伝導しない。逆に、顎部材210および220が閾値角度を超えて閉鎖されるとき、センサー240は末端コネクター250に対向して(または対して)位置決めされ、そして信号を発電機501に対して戻して伝導し、起動を可能にする。
図1Bを参照して、いくつかの実施形態では、一連のセンサー、例えば、センサー140aおよび140bは、駆動スリーブ160に沿って、またはその遠位端に、顎部材110と120との間の相対的角度「α」が、より微細な分解能のために別個の単位に分割され得るように採用され得る。例えば、2つのセンサー140aおよび140bが顎部材210と220との間の相対的角度を決定するために利用される事例では、個々のセンサー140aおよび140bとコネクター130との間の各電気的接続の伝導度の状態に関する情報は、バイナリーフォーマット、例えば、「00」(センサー143aまたは143bいずれかとの接触なし);「01」(第1のセンサー143aと接触);「11」(両方のセンサー143aおよび143bと接触);および「10」(第2のセンサー143bと接触)で、配線133、143aおよび143bをそれぞれ経由して、発電機501に戻して連絡され得る。
図3は、顎角度「α」を決定するために、可変抵抗器340、例えば、電圧分割機ネットワーク(「VDN」)を利用するなお別の鉗子300を示す。VDN340は、スイッチ閉鎖を形成するフィルムタイプのポテンショメーターであり得る。本明細書中の目的には、用語「電圧分割機ネットワーク」は、直列に接続された電圧供給源(例えば、2つのインピーダンスの1つ)を横切る出力電圧を決定する抵抗性、容量性または誘導性スイッチ閉鎖(など)の任意の適切な形態に関する。本明細書で用いられるとき、用語「電圧分割機」は、一定または可変の割合の印加された電圧を利用可能にする特定点におけるタップが提供される直列に接続された多くの抵抗器に関する。
示される実施形態では、作動ピン330は、VDN340を横切る接点として、作動ピン330がシャフト312内のスロット345、ならびに顎部材310および320中の個々のカムスロット374および372内で動かされるとき、この作動ピン330がVDN340に対して移動し得、それによって発電機501にリレーされて戻される信号の強度を変え、それが、次に顎角度「α」を決定するために利用され得るように作用し得る。さらなる配線(図示はされていない)がこの目的を達成するために必要であり得るが、顎角度「α」のより微細な分解能が決定され得る。
図4Aおよび4Bは、顎角度「α」を決定するための類似のスタイルのセンサー配列を有する開放鉗子400の別の実施形態を示す。より詳細には、鉗子400は、旋回点450の周りで互いに対して移動可能である2つの対向する顎部材410および420を含む。各顎部材410および420は、それから近位方向に延びるフランジ442および432を含む。フランジ432は、VDN430を収容するフランジ442上に配置された相補的インターフェース431内に機械的に受容されている接点440を含む。顎部材410および420の開放位置から閉鎖位置までの移動の間に、接点440は、接点440がVDN(または一連の抵抗器)を横切って移動するとき、(図4Aに示されるような)インターフェース431に対して間隔を置いた位置から、インターフェース431内の一連の引き続く位置に移動し、それによって、顎角度「α」を決定するための発電機501にリレーして戻る信号の強度を変える。
図5は、鉗子500の別の実施形態を示し、ここで、駆動アクチュエーター550は、2つの対向する顎部材、例えば、顎部材110および120間の顎角度「α」を決定するための可変キャパシター520を含むように改変されている。より詳細には、可変キャパシター520は、例えば、駆動アクチュエーター560上に配置された第2のコンダクター、例えば、伝導性リング530をカプセル化する鉗子ハウジング(図示はされていない)または顎部材110および120上に配置された固定されたコンダクター、例えば、゛伝導性リング540を含む。駆動アクチュエーター550の移動は、伝導性リング530を伝導性リング540にたいして移動する。誘電性絶縁体(図示はされていない)が、2つのリング530および540の間に配置され得る(例えば、空気または絶縁性潤滑剤)。
駆動アクチュエーター560が顎部材110および120の近くに移動するとき、伝導性リング530は固定された伝導性リング540に対して移動し、それによって、図6に関して以下に説明される容量性感知回路600に基づき、2つの伝導性リング530と540との間の静電容量を変える。静電容量における変化が検出され、そして発電機501またはコントローラー502に伝達され、2つの顎部材110と120との間の顎角度「α」を決定する。1つの実施形態では、これら伝導性リング530および540は両方とも互いに対して移動可能であり得、同様の目的を達成する。
図6は、図5に関して説明された実施形態との使用のための可変静電容量回路600の1つの例を示す。上記で述べたように、伝導性リング540および530は、発電機501および回路600に信号を戻して伝達する可変キャパシター520を形成する。この可変キャパシター520の電圧供給源(+5Vと標識される)への連結は、S2が開かれ、S3が開かれ、そしてS1が閉じられるとき、可変キャパシター520が充電するようにする。所定長さの時間の後、S1が開き、そしてS2が閉じる。これは、可変キャパシター520上蓄えられた電荷が、電荷キャパシター620に移されるようにする。S2が、次いで開き、そしてこのプロセスは、所定の数のサイクルの間繰り返される。電荷キャパシター620上で得られる電圧が、次いで、読み取られ得る(この場合には、アナログ−デジタルコンバーター630による)。S3が次いで閉じられ、そして再び開けられて電荷キャパシター620を放電する。全体のサイクルが、次いで、所望の読み取り速度で繰り返される。読み取られた電圧は、可変キャパシター520の静電容量に比例し、これは、次に、顎部材、例えば顎部材110および120間の顎角度「α」に関連する。
前述から、そして種々の図面の描写を参照して、当業者は、本開示の範囲から逸脱することなく本開示に特定の改変がまたなされ得ることがを認識する。例えば、1つ以上の停止部材が、顎部材の1つまたは両方の電気的に伝導性の封止表面に隣接して、またはその上に配置され得、これら伝導性表面間のギャップ距離を調節する。これら電気的に伝導性の表面から延びる停止部材の距離は、顎部材間の顎角度「α」に影響し得る。発電機は、上記で述べたような全体の顎角度「α」および任意のタイプの閾値角度を決定するとき、この特徴を行うために(自動的に、または手動で)プログラムされなければならないかも知れない。さらに、組織厚みがまた、顎角度「α」に影響し得る。再び、発電機は、これら種々の組織タイプを補償するために(自動的に、または手動で)プログラムされなければならないかも知れない。
本明細書中に記載される1つ以上の顎閉鎖検出器は、封止プロセスの間の時間の期間に亘り、顎閉鎖角度「α」における変化を検出するような形態であり得る。この情報はまた、得られる封止のシールの質および全体の成功を決定するために発電機にリレーして戻され得る。
いくつかの実施形態では、本明細書中に記載される任意の顎閉鎖検出器は、発電機501に電気的に連結されているコントローラー502(図1A)に連結され得るか、または、いくつかの例では、この発電機501から独立している。(独立であるとき)コントローラー502は、発電機501に関して本明細書中に記載された特徴のいずれか、または全部を提供するような形態であり得る。
本開示のいくつかの実施形態が、図面中に示され、そして/または本明細書中で論議されているが、本開示はそれらに制限されることは意図されない。なぜなら、本開示は、当該技術分野が許容し、しかも本明細書が同様に読まれる範囲が広いことが意図されるからである。従って、上記の説明は、制限的であると解釈されるべきでなく、特定の実施形態の例示に過ぎない。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。
(要約)
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。
10 一側性腹腔鏡血管封止鉗子
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)

  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。
  2. 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。
  3. 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。
  4. 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。
  5. 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。
  6. 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。
  7. 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。
  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。
  9. 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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US8764749B2 (en) 2014-07-01

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