JP2010075690A - 外科用器具のための組織止め - Google Patents
外科用器具のための組織止め Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
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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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07221—Stapler heads curved
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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
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B2017/07214—Stapler heads
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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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
- A61B2017/2945—Curved 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
- 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
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
- A61B2018/1432—Needle curved
Abstract
【課題】組織を外科的に接合するための外科用器具を提供すること。
【解決手段】組織を外科的に接合するための外科用器具であって、ハンドルアセンブリと、該ハンドルアセンブリから遠位方向に延び、長手方向軸を画定する細長い部分と、該細長い部分の遠位部分に隣接して配置されたエンドエフェクタであって、該エンドエフェクタは、第１の顎部材と第２の顎部材とを含み、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材のかなりの部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能である、ストップ部材とを備えている外科用器具。
【選択図】図１
【解決手段】組織を外科的に接合するための外科用器具であって、ハンドルアセンブリと、該ハンドルアセンブリから遠位方向に延び、長手方向軸を画定する細長い部分と、該細長い部分の遠位部分に隣接して配置されたエンドエフェクタであって、該エンドエフェクタは、第１の顎部材と第２の顎部材とを含み、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材のかなりの部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能である、ストップ部材とを備えている外科用器具。
【選択図】図１
Description
本開示は概して、外科用器具に関し、より詳細には、外科的に組織を接合するための外科用器具に関する。
圧縮された生体組織を貫通してステープルの平行な列を適用するために使用される外科用ステープリング器具は、当技術分野で公知である。これらの外科用器具は普通、離断または切除の前に組織または器官を閉じるために、胸部の処置および腹部の処置に際して器官を閉塞するために、および吻合に際して組織を締め付けるために使用される。
通常、かかる外科用ステープリング器具は、アンビルアセンブリと、外科用ステープルのアレイを支持するためのカートリッジアセンブリと、アンビルアセンブリとカートリッジアセンブリとを接近させるための接近メカニズムと、カートリッジアセンブリから外科用ステープルを排出するための発射メカニズムとを含む。
使用に際して、外科医は概して最初に、アンビル部材とカートリッジ部材とを接近させる。次に、外科医は、器具を発射させて、ステープルを組織に配置し得る。さらに、外科医は、同じ器具または別個の器具を使用して、ステープルの列に隣接する組織またはステープルの列の間の組織を切断し得る。あるいは、外科用ステープリング器具は、アンビルとカートリッジが接近させられている間に、連続してステープルを排出し得る。
（概要）
本開示は、組織を外科的に接合するための外科用器具に関する。外科用器具は、ハンドルアセンブリと、細長い部分と、エンドエフェクタと、ストップ部材とを含む。細長い部分は、ハンドルアセンブリから遠位方向に延びる。エンドエフェクタは、細長い部分の遠位部分に隣接して配置され、第１の顎部材と第２の顎部材とを含む。少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で、他方の顎部材に対して可動である。ストップ部材は、第１の顎部材の遠位部分に隣接して配置され、ストップ部材のかなりの部分が第１の顎部材の外部に位置決めされる第１の位置と、第１の顎部材と第２の顎部材との間で組織を捕捉する第２の位置との間で、第１の顎部材に対して旋回可能である。
本開示は、組織を外科的に接合するための外科用器具に関する。外科用器具は、ハンドルアセンブリと、細長い部分と、エンドエフェクタと、ストップ部材とを含む。細長い部分は、ハンドルアセンブリから遠位方向に延びる。エンドエフェクタは、細長い部分の遠位部分に隣接して配置され、第１の顎部材と第２の顎部材とを含む。少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で、他方の顎部材に対して可動である。ストップ部材は、第１の顎部材の遠位部分に隣接して配置され、ストップ部材のかなりの部分が第１の顎部材の外部に位置決めされる第１の位置と、第１の顎部材と第２の顎部材との間で組織を捕捉する第２の位置との間で、第１の顎部材に対して旋回可能である。
様々な実施形態において、カートリッジは長手方向軸に対して湾曲している。
外科用器具は、ストップ部材と機械的に協働するように配置された付勢部材をさらに含み得、該付勢部材は、その第１の位置に向けてストップ部材を付勢する。
特定の実施形態において、ストップ部材は、ベースとストッピング部分とを含み、該ベースは、該ストッピング部分に動作可能に接続されている。一部の実施形態において、ストッピング部分はベースに旋回可能に接続されている。あるいは、ストップ部材は、第１の顎部材に旋回可能に結合され得る。
第１の顎部材は、ナイフチャンネルを含み得る。ストップ部材は、ナイフチャンネルの相対する側に配置された第１のレグと第２のレグとをさらに含み得る。
外科用器具は、第１の顎部材に配置された第１のスロットと第２のスロットとをさらに含み得る。第１のスロットおよび第２のスロットの各々は、第１のレグおよび第２のレグのうちの１つの少なくとも一部分をその中に受け入れるように適合される。一部の実施形態において、第１のレグおよび第２のレグの各々は、ストップ部材が、その第２の位置に向かって動くとき、第１のスロットまたは第２のスロットを少なくとも部分的に通って動くように構成されている。
さらに、本開示は、外科器具との使用のためのツールアセンブリに関する。一般に、このツールアセンブリは、エンドエフェクタとストップ部材とを含む。エンドエフェクタは、第１の顎部材および第２の顎部材を有する。少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である。ストップ部材は、第１の顎部材の遠位部分に隣接して配置され、ストップ部材の少なくとも一部分が、第１の顎部材の外部に位置決めされる第１の位置と、第１の顎部材と第２の顎部材との間で組織を捕捉する第２の位置との間で、第１の顎部材に対して旋回可能であり、ストップ部材の少なくとも一部分が、第１の顎部材の組織接触表面の少なくとも部分的に下に位置決めされ、接近させられた位置に向かう顎部材の相対的な動きは、ストップ部材の少なくとも一部分を第１の顎部材に向かって動かす。
一部の実施形態において、エンドエフェクタは、長手方向に曲線をなす形状を含む。さらに、特定の実施形態において、ストップ部材は、第１の位置に向かって付勢される。第１の顎部材は、そこに形成された少なくとも１つのスロットを含み得る。このスロットは、ストップ部材の少なくとも一部分を受け入れるように構成される。
本開示は、外科用器具との使用のために構成されたストップ部材にも関する。ストップ部材は、外科用器具の顎部材と機械的に係合するように構成されたベース部分と、ストッピング部分とを含む。ストッピング部分は、ベース部分と旋回可能に係合され、第１の位置と第２の位置との間で可動である。第１の位置において、ストッピング部分は、組織が、ストッピング部分に対して近位方向に動かされることを容易にするように構成される。第２の位置において、ストッピング部分は、組織がストッピング部分を越えて遠位方向に並進することを抑止するように構成される。
本発明は、さらに以下の手段を提供する。
（項目１Ａ）
組織を外科的に接合するための外科用器具であって、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位方向に延び、長手方向軸を画定する細長い部分と、
該細長い部分の遠位部分に隣接して配置されたエンドエフェクタであって、該エンドエフェクタは、第１の顎部材と第２の顎部材とを含み、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材のかなりの部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能である、ストップ部材と
を備えている外科用器具。
組織を外科的に接合するための外科用器具であって、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位方向に延び、長手方向軸を画定する細長い部分と、
該細長い部分の遠位部分に隣接して配置されたエンドエフェクタであって、該エンドエフェクタは、第１の顎部材と第２の顎部材とを含み、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材のかなりの部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能である、ストップ部材と
を備えている外科用器具。
（項目２Ａ）
上記カートリッジは、上記長手方向軸に対して湾曲している、上記項目のいずれか一項に記載の外科用器具。
上記カートリッジは、上記長手方向軸に対して湾曲している、上記項目のいずれか一項に記載の外科用器具。
（項目３Ａ）
上記ストップ部材と機械的に協働するように配置された付勢部材をさらに備え、該付勢部材は、該ストップ部材をその第１の位置に向けて付勢する、上記項目のいずれか一項に記載の外科用器具。
上記ストップ部材と機械的に協働するように配置された付勢部材をさらに備え、該付勢部材は、該ストップ部材をその第１の位置に向けて付勢する、上記項目のいずれか一項に記載の外科用器具。
（項目４Ａ）
上記ストップ部材は、ベースとストッピング部分とを含み、該ベースは、該ストッピング部分と動作可能に接続されている、上記項目のいずれか一項に記載の外科用器具。
上記ストップ部材は、ベースとストッピング部分とを含み、該ベースは、該ストッピング部分と動作可能に接続されている、上記項目のいずれか一項に記載の外科用器具。
（項目５Ａ）
上記ストッピング部分は、上記ベースと旋回可能に接続されている、上記項目のいずれか一項に記載の外科用器具。
上記ストッピング部分は、上記ベースと旋回可能に接続されている、上記項目のいずれか一項に記載の外科用器具。
（項目６Ａ）
上記ストップ部材は、上記第１の顎部材に旋回可能に結合されている、上記項目のいずれか一項に記載の外科用器具。
上記ストップ部材は、上記第１の顎部材に旋回可能に結合されている、上記項目のいずれか一項に記載の外科用器具。
（項目７Ａ）
上記第１の顎部材は、ナイフチャンネルを含む、上記項目のいずれか一項に記載の外科用器具。
上記第１の顎部材は、ナイフチャンネルを含む、上記項目のいずれか一項に記載の外科用器具。
（項目８Ａ）
上記ストップ部材の第１のレグおよび第２のレグをさらに備え、該第１のレグおよび該第２のレグは、上記ナイフチャンネルの相対する側に位置決めされている、上記項目のいずれか一項に記載の外科用器具。
上記ストップ部材の第１のレグおよび第２のレグをさらに備え、該第１のレグおよび該第２のレグは、上記ナイフチャンネルの相対する側に位置決めされている、上記項目のいずれか一項に記載の外科用器具。
（項目９Ａ）
上記第１の顎部材に配置された第１のスロットおよび第２のスロットをさらに備え、該第１のスロットおよび該第２のスロットの各々は、上記第１のレグおよび上記第２のレグのうちの１つの少なくとも一部分をその中に受け入れるように適合されている、上記項目のいずれか一項に記載の外科用器具。
上記第１の顎部材に配置された第１のスロットおよび第２のスロットをさらに備え、該第１のスロットおよび該第２のスロットの各々は、上記第１のレグおよび上記第２のレグのうちの１つの少なくとも一部分をその中に受け入れるように適合されている、上記項目のいずれか一項に記載の外科用器具。
（項目１０Ａ）
上記第１のレグおよび上記第２のレグの各々は、上記ストップ部材が、その第２の位置に向かって動くとき、上記第１のスロットまたは上記第２のスロットを少なくとも部分的に通って動くように構成されている、上記項目のいずれか一項に記載の外科用器具。
上記第１のレグおよび上記第２のレグの各々は、上記ストップ部材が、その第２の位置に向かって動くとき、上記第１のスロットまたは上記第２のスロットを少なくとも部分的に通って動くように構成されている、上記項目のいずれか一項に記載の外科用器具。
（項目１１Ａ）
外科用器具との使用のためのツールアセンブリであって、該ツールアセンブリは、
第１の顎部材と第２の顎部材とを含むエンドエフェクタであって、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材は、該ストップ部材の少なくとも一部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能であり、該接近させられた位置に向かう該顎部材の相対的な動きは、該ストップ部材の少なくとも一部分を該第１の顎部材に向かって動かす、ストップ部材と
を備えている、ツールアセンブリ。
外科用器具との使用のためのツールアセンブリであって、該ツールアセンブリは、
第１の顎部材と第２の顎部材とを含むエンドエフェクタであって、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材は、該ストップ部材の少なくとも一部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能であり、該接近させられた位置に向かう該顎部材の相対的な動きは、該ストップ部材の少なくとも一部分を該第１の顎部材に向かって動かす、ストップ部材と
を備えている、ツールアセンブリ。
（項目１２Ａ）
上記エンドエフェクタは、長手方向に曲線をなす形状を含む、上記項目のいずれか一項に記載のツールアセンブリ。
上記エンドエフェクタは、長手方向に曲線をなす形状を含む、上記項目のいずれか一項に記載のツールアセンブリ。
（項目１３Ａ）
上記ストップ部材は、上記第１の位置に向かって付勢される、上記項目のいずれか一項に記載のツールアセンブリ。
上記ストップ部材は、上記第１の位置に向かって付勢される、上記項目のいずれか一項に記載のツールアセンブリ。
（項目１４Ａ）
上記第１の顎部材は、そこに形成された少なくとも１つのスロットを含み、該少なくとも１つのスロットは、上記ストップ部材の少なくとも一部分を受け入れるように構成されている、上記項目のいずれか一項に記載のツールアセンブリ。
上記第１の顎部材は、そこに形成された少なくとも１つのスロットを含み、該少なくとも１つのスロットは、上記ストップ部材の少なくとも一部分を受け入れるように構成されている、上記項目のいずれか一項に記載のツールアセンブリ。
（項目１５Ａ）
外科用締め具によって組織を締め付けるためのシステムであって、該システムは、
第１の顎部材および第２の顎部材であって、該第１の顎部材および該第２の顎部材は、それらの間に組織を配置するように構成され、該第１の顎部材は、組織を係合するため、該第２の顎部材に対して旋回されるように構成されている、第１の顎部材および第２の顎部材と、
該第１の顎部材と該第２の顎部材との間に配置されたストップ部材であって、該第１の顎部材と該第２の顎部材との間に組織を維持するため、旋回されるように構成され、該顎の遠位端に配置されている、ストップ部材と
を備えている、システム。
外科用締め具によって組織を締め付けるためのシステムであって、該システムは、
第１の顎部材および第２の顎部材であって、該第１の顎部材および該第２の顎部材は、それらの間に組織を配置するように構成され、該第１の顎部材は、組織を係合するため、該第２の顎部材に対して旋回されるように構成されている、第１の顎部材および第２の顎部材と、
該第１の顎部材と該第２の顎部材との間に配置されたストップ部材であって、該第１の顎部材と該第２の顎部材との間に組織を維持するため、旋回されるように構成され、該顎の遠位端に配置されている、ストップ部材と
を備えている、システム。
（項目１５Ｂ）
外科用締め具によって組織を締め付ける方法であって、該方法は、
第１の顎部材と第２の顎部材との間に組織を配置することと、
組織と係合するように、該第１の顎部材を該第２の顎部材に対して旋回させることと、
該第１の顎部材と該第２の顎部材との間に組織を維持するように、該第１の顎部材と該第２の顎部材との間に配置されたストップ部材を旋回させることであって、該ストップ部材は、該顎の遠位端に配置されている、ことと
を包含する、方法。
外科用締め具によって組織を締め付ける方法であって、該方法は、
第１の顎部材と第２の顎部材との間に組織を配置することと、
組織と係合するように、該第１の顎部材を該第２の顎部材に対して旋回させることと、
該第１の顎部材と該第２の顎部材との間に組織を維持するように、該第１の顎部材と該第２の顎部材との間に配置されたストップ部材を旋回させることであって、該ストップ部材は、該顎の遠位端に配置されている、ことと
を包含する、方法。
（摘要）
ハンドルアセンブリと、細長い部分と、エンドエフェクタと、ストップ部材とを含む外科用器具が開示される。細長い部分は、ハンドルアセンブリから遠位方向に延びる。エンドエフェクタは、細長い部分の遠位部分に隣接して配置され、第１の顎部材と第２の顎部材とを含む。少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である。ストップ部材は、第１の顎部材の遠位部分に隣接して配置され、ストップ部材のかなりの部分が第１の顎部材の外部に位置決めされる第１の位置と、第１の顎部材と第２の顎部材との間で組織を捕捉する第２の位置との間で、第１の顎部材に対して旋回可能である。
ハンドルアセンブリと、細長い部分と、エンドエフェクタと、ストップ部材とを含む外科用器具が開示される。細長い部分は、ハンドルアセンブリから遠位方向に延びる。エンドエフェクタは、細長い部分の遠位部分に隣接して配置され、第１の顎部材と第２の顎部材とを含む。少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である。ストップ部材は、第１の顎部材の遠位部分に隣接して配置され、ストップ部材のかなりの部分が第１の顎部材の外部に位置決めされる第１の位置と、第１の顎部材と第２の顎部材との間で組織を捕捉する第２の位置との間で、第１の顎部材に対して旋回可能である。
本開示の外科用器具の様々な実施形態が、図面を参照して本明細書に開示される。
図１は、本開示の外科用器具の実施形態の斜視図である。
図２〜図４は、図１の外科用器具の一部分の斜視図であり、第１の位置にあるストップ部材を示している。
図２〜図４は、図１の外科用器具の一部分の斜視図であり、第１の位置にあるストップ部材を示している。
図２〜図４は、図１の外科用器具の一部分の斜視図であり、第１の位置にあるストップ部材を示している。
図５〜図７は、図１の外科用器具のエンドエフェクタの側面図であり、動作の様々な段階において示されている。
図５〜図７は、図１の外科用器具のエンドエフェクタの側面図であり、動作の様々な段階において示されている。
図５〜図７は、図１の外科用器具のエンドエフェクタの側面図であり、動作の様々な段階において示されている。
図８は、図１の外科用器具の一部分の斜視図であり、その第２の位置に隣接したストップ部材を示している。
図９は、本開示の別の実施形態による湾曲した顎部材の斜視図であり、第１の位置にあるストップ部材を示す。
図１０は、図９の湾曲した顎部材の斜視分解図である。
図１１は、図９の湾曲した部材の斜視図であり、図９の切断線１１−１１に沿った遠位部分の断面を示す。
図１２は、図９の湾曲した顎部材の斜視図であり、第２の位置にあるストップ部材を示す。
（詳細な説明）
本開示の外科用器具の実施形態が、図面を参照して詳細に記述され、該図面においては、同様の参照番号は、幾つかの図面の各々において、同様のまたは同一の要素を示す。図面および以下の記述において、用語「近位の」は、オペレータに最も近い外科用器具の端を指し、一方、用語「遠位の」は、オペレータから最も遠い外科用器具の端を指す。当業者によって理解されるように、図示された外科用器具はステープルを発射するが、例えばクリップおよび２部分締め具のような任意の他の適切な締め具を発射するように適合され得る。さらに、開示されたストップ部材は、電気外科用鉗子に対して使用され得る。電気外科用鉗子のさらなる詳細が、２００３年２月２０日に出願された「ＶＥＳＳＥＬ ＳＥＡＬＥＲ ＡＮＤ ＤＩＶＩＤＥＲ ＡＮＤ ＭＥＴＨＯＤ ＯＦ ＭＡＮＵＦＡＣＴＵＲＩＮＧ ＴＨＥ ＳＡＭＥ」と題する、共有に係る特許出願第１０／３６９，８９４号に記述され、該特許出願の全容が、本明細書に参考として援用されている。
本開示の外科用器具の実施形態が、図面を参照して詳細に記述され、該図面においては、同様の参照番号は、幾つかの図面の各々において、同様のまたは同一の要素を示す。図面および以下の記述において、用語「近位の」は、オペレータに最も近い外科用器具の端を指し、一方、用語「遠位の」は、オペレータから最も遠い外科用器具の端を指す。当業者によって理解されるように、図示された外科用器具はステープルを発射するが、例えばクリップおよび２部分締め具のような任意の他の適切な締め具を発射するように適合され得る。さらに、開示されたストップ部材は、電気外科用鉗子に対して使用され得る。電気外科用鉗子のさらなる詳細が、２００３年２月２０日に出願された「ＶＥＳＳＥＬ ＳＥＡＬＥＲ ＡＮＤ ＤＩＶＩＤＥＲ ＡＮＤ ＭＥＴＨＯＤ ＯＦ ＭＡＮＵＦＡＣＴＵＲＩＮＧ ＴＨＥ ＳＡＭＥ」と題する、共有に係る特許出願第１０／３６９，８９４号に記述され、該特許出願の全容が、本明細書に参考として援用されている。
図１を参照すると、参照番号１００は、本開示の外科用器具の実施形態を示す。簡潔さのために、本開示は、外科用器具１００のエンドエフェクタおよびストップ部材に焦点を当てる。２００７年１１月２８日に出願された米国特許出願公開第２００８／０１０５７３０号、２００８年１月８日に出願された米国特許出願公開第２００８／０１１０９６０号、２００８年１月２４日に出願された米国特許出願公開第２００８／０１４２５６５号、２００７年１０月１５日に出願された米国特許出願公開第２００８／００４１９１６号、ならびに２００８年５月５日に出願された米国仮特許出願第６１／０５０２７３号および２００７年４月１０日に出願された米国仮特許出願第１１／７８６，１９８号が、他の外科用締め付けアセンブリの構造および動作を詳細に記述している。これらの先行出願の全容が、本明細書に参考として援用されている。引用された特許出願において開示された外科用締め付けアセンブリのうちのいずれもが、本開示のストップ部材を含み得る。
外科用器具１００は、組織を締め、締め付け、かつ／または切断するように構成されている。一般に、外科用器具１００は、ハンドルアセンブリ１６０と、ハンドルアセンブリ１６０から遠位方向に延び、長手方向軸「Ａ−Ａ」を画定する細長い部分１２０と、組織をクランプし、締め付けるように適合されたツールアセンブリ１５０とを含む。細長い部分１２０は、近位部分１２２および遠位部分１２４を有し、ハンドルアセンブリ１６０をツールアセンブリ１５０と動作可能に結合する。ツールアセンブリ１５０は、エンドエフェクタ１５４とストップ部材１７０とを含む。細長い部分１２０の遠位部分１２４に隣接して配置されたエンドエフェクタ１５４は、第１の顎部材１３０と第２の顎部材１４０とを含む。顎部材１３０、１４０のうちの少なくとも１つは、間隔が置かれた位置と接近させられた位置との間で他の顎部材（１３０または１４０）に対して動くように適合される。図示された実施形態において、第１の顎部材１３０は、カートリッジアセンブリ１３２を含み、一方、第２の顎部材１４０は、アンビルアセンブリ１４２を含む。下に論議されるように、アンビルアセンブリ１４２は、例えば、ハンドルアセンブリ１６０が作動すると、間隔が置かれた位置と接近させられた位置との間で、カートリッジアセンブリ１３２に対して動く。しかしながら、クランプバー１６８をスライドさせることを含んで、顎部材を接近させる他の方法も使用可能であることも想定されている。
ハンドルアセンブリ１６０は、固定ハンドル１６２と可動ハンドル１６４とを含む。可動ハンドル１６４は、固定ハンドル１６２に向かって、またはこれから遠ざかるように、旋回可能に動くように適合される。さらに、可動ハンドル１６４は、メカニズムによってアンビルアセンブリ１４０に動作可能に接続され、該メカニズムは、可動ハンドル１６４の少なくとも部分的な作動を、カートリッジアセンブリ１３２およびアンビルアセンブリ１４２のうちの少なくとも１つの、間隔が置かれた位置と接近させられた位置との間での旋回運動に変換するように適合される。当業者によって認識されるように、可動ハンドル１６４をツールアセンブリ１５０に動作可能に結合するために、任意の従来の作動メカニズムが使用され得る。
図２〜図５を参照すると、カートリッジアセンブリ１３２は、組織接触表面１３４および複数の締め具保持スロット１３６を有する。組織接触表面１３４は概して、アンビルアセンブリ１４２（図１を参照）に面し、動作の間、アンビルアセンブリ１４２がカートリッジアセンブリ１３２と接近させられると、組織と係合する。締め具保持スロット１３６は、組織接触表面１３４に沿って列に配列される。各締め具保持スロット１３６は、例えば、ユーザがハンドルアセンブリ１６０（図１を参照）を作動させるまで、締め具（図示されず）を保持するように適合される。可動ハンドル１６４が、固定ハンドル１６２に向かって旋回させられると、締め具は、締め具保持スロット１３６から排出され、アンビルアセンブリ１４２に向かって動く。
締め具保持スロット１３６に加えて、カートリッジアセンブリ１３２は、ナイフチャンネル１３８を有し、ナイフチャンネル１３８は、ナイフ（図示されず）または任意の他の適切な切断ツールをスライド可能に受け入れるように適合される。ナイフチャンネル１３８は、締め具保持スロット１３６の列の間に配置され、組織接触表面１３４に沿って延びる。動作において、ナイフ（図示されず）は、可動ハンドル１６４が、固定ハンドル１６２に向かって旋回するとき、ナイフチャンネル１３８を通ってスライドする。あるいは、他のメカニズムが、ナイフをナイフチャンネル１３８を通して駆動するために使用され得る。ナイフチャンネル１３８に加えて、カートリッジアセンブリ１３２は、組織接触表面１３４に形成された一対のスロット１３９を有する。各スロット１３９は、カートリッジアセンブリ１３２の内側部分へのアクセスを提供し、ストップ部材１７０の部分を受け入れるように構成される。
開示された実施形態において、ハンドルアセンブリ１６０は、締め具保持スロット１３６から締め具を配備し、そしてナイフチャンネル１３８に沿ってナイフを前進させるための作動メカニズムを含む。作動メカニズムは、可動ハンドル１６４に動作可能に接続された発射ロッドを含む。動作において、可動ハンドル１６４を固定ハンドル１６２に向かって旋回させることは、発射ロッドを遠位方向に前進させる。発射ロッドは次に、少なくとも部分的にツールアセンブリ１５０内に位置決めされた軸駆動アセンブリに動作可能に結合される。軸駆動アセンブリは、発射ロッドの遠位方向の並進に応答して、遠位方向に動くように構成される。軸駆動アセンブリの遠位方向の並進は、第２の顎部材１４０を第１の顎部材１３０に向かって旋回させる。さらに、軸駆動アセンブリは、第１の顎部材１３０内に配置された作動スレッドを遠位方向に押し、一方、作動スレッドは、エンドエフェクタ１５４を通って遠位方向に並進する。作動スレッドが、第１の顎部材１３０を通って遠位方向に前進すると、この作動スレッドは、締め具保持スロット１３６の外へ出るように締め具を促す。一実施形態において、軸駆動アセンブリは、その遠位部分に取り付けられたブレードを含む。動作において、このナイフは、軸駆動アセンブリがエンドエフェクタ１５４を通って遠位方向に動くと、ナイフチャンネル１３８を通って動く。
ストップ部材１７０は、第１の顎部材１３０（カートリッジアセンブリ１３２として示されているが、アンビルアセンブリ１４２でもあり得る）の遠位部分１３７に隣接して配置される。ストップ部材１７０は、図５に示されたとおりの第１の位置と、図７に示されたとおりの第２の位置との間で第１の顎部材１３０に対して旋回可能である。第１の位置において、ストップ部材１７０の少なくとも一部分が、第１の顎部材１３０の外部に位置し、一方、第２の位置において、ストップ部材１７０の少なくとも一部分が、第１の顎部材１３０の組織接触表面１３４の少なくとも部分的に下に位置決めされる。様々な実施形態において、ストップ部材１７０が第１の位置にあるとき、ストップ部材１７０のかなりの部分が、第１の顎部材１３０の外部に配置される。用語「かなりの」は、ストップ部材１７０の各レグ１７７の少なくとも半分が、ストップ部材１７０が第１の位置にあるとき、第１の顎部材１３０の外部に配置されることを意味することが想定される。さらに、本明細書に使用されているように、「かなりの」は、ストップ部材１７０の三分の一よりも多くが、ストップ部材１７０が第１の位置にあるとき、第１の顎部材１３０の外側に配置されることを意味し得る。
ストップ部材１７０は、第１の顎部材１３０の遠位部分１３７の外側表面と係合するように適合されたベース１７２と、組織と係合するように適合されたストッピング部分１７４とを含む。旋回ピン１７６、または任意の他の適切な装置は、ストッピング部分１７４をベース１７２に旋回可能に接続する。したがって、ストッピング部分１７４は、組織接触表面１３４から遠ざかり、かつこれに向かって旋回するように構成される。一実施形態において、ストップ部材１７０は、ストッピング部分１７４を第１の顎部材１３０から遠ざかるように付勢する付勢部材（例えばバネ）を含む。
ストッピング部分１７４は、本体１７５と本体１７５から近位方向に延びる少なくとも１つのレグ１７７とを含む。図２に示される実施形態において、ストッピング部分１７４は、本体１７５から近位方向に延びる２つのレグ１７７を有する。しかしながら、ストッピング部分１７４は、より多くのまたはより少ないレグ１７７を含み得る。図２に示される２つのレグ１７７は、ナイフを受け入れるように適合されたスペースをそれらの間に画定する。各レグ１７７は、スロット１３９内に受け入れられるような大きさとされ、近位表面１７３を含む。ストップ部材１７０が第１の位置にあるとき、各近位表面１７３は、図５に見られるように、組織接触表面１３４に対して斜角を画定する。逆に、ストップ部材１７０が、第２の位置にあるとき（図７を参照）、各近位表面１７３は、組織接触表面１３４に対して実質的に垂直の角度を画定する。ストップ部材１７０の位置に関わりなく、レグ１７７は、ナイフチャンネル１３８の相対する側に位置決めされて示される。したがって、レグ１７７を受け入れるような大ききさとされたスロット１３９も、ナイフチャンネル１３８の相対する側に位置する。
図６〜図８を参照すると、ストップ部材１７０は、外科用器具１００の動作の間、第１の顎部材１３０と第２の顎部材１４０との間で組織の保持を容易にする。（図１を参照）。すなわち、ストップ部材１７０は、組織が、顎部材間のその意図された配置を越えて遠位方向に移動または並進することを防止することを助ける。使用に際して、ユーザは最初に、標的組織に隣接して器具１００を位置決めする。特に、標的組織は、第１の顎部材１３０と第２の顎部材１４０との間に配置される。図６に見られるように、組織接触表面１３４に対して本体１７５によって画定された角度は、標的組織「Ｔ」をツールアセンブリ１５０の中に概ね矢印「Ａ」の方向に導入することを容易にする。一旦ユーザが、第１の顎部材１３０と第２の顎部材１４０との間に標的組織の少なくとも一部分を配置すると、ユーザは、可動ハンドル１６４を固定ハンドル１６２に向かって引き、アンビルアセンブリ１４２をカートリッジアセンブリ１３２に向かって接近させる。ユーザが、可動ハンドル１６４を引く間に、アンビルアセンブリ１４２は、カートリッジアセンブリ１３２に近づき、標的組織「Ｔ」は、カートリッジアセンブリ１３２の組織接触表面１３４との間で捕捉される。同時に、アンビルアセンブリ１４２は、ストッピング部分１７４をカートリッジアセンブリ１３２に向かって促す。アンビルアセンブリ１４２によってストッピング部分１７４に対して及ぼされた力に応答して、ストッピング部分１７４は、例えば付勢部材（図示されず）の付勢に抗して、カートリッジアセンブリ１３２に向かって、旋回ピン１７６回りに旋回する。図７に見られるように、ストッピング部分１７４が、カートリッジアセンブリ１３２に近づく間に、レグ１７７の少なくとも一部分は、スロット１３９を通ってカートリッジアセンブリ１３２の内側部分の方に動く。ストップ部材１７０が、第２の位置にあるとき（図７に示されるように）、レグ１７７の一部分は、カートリッジアセンブリ１３２内に位置する。これに対応して、近位表面１７３の一部分は、カートリッジアセンブリ１３２の外側に位置する。上に論議されたように、近位表面１７３は、ストップ部材１７０が第２の位置にあるとき、組織接触表面１３４に対して実質的に直交する角度を確定し、それによって締め付けの間に組織が逃避することを妨げる。
本開示は、従来の機械的手段、例えば差込みカップリング、ラッチ、もどり止めまたはスナップ嵌め接続を介してエンドエフェクタ１５０に解放可能に取り付け可能であるストップ部材１７０も想定している。
図９〜図１２を参照すると、第１の顎部材２３０の別の実施形態が想定されている。この実施形態の第１の顎部材２３０は、湾曲した形状（すなわち、長手方向軸「Ａ−Ａ」に対して）を有する。湾曲したあご部材は、外科処置の特定のタイプを実行することを容易にし得ることが想定されている。例えば、湾曲した顎部材は、真直ぐな顎部材（例えば図１に示されたような顎部材）と比較して、例えば低位前方切除（「ＬＡＲ」）または他の結腸直腸外科手術の間、下部骨盤領域へのアクセスを容易にすることを助け得る。
第１の顎部材２３０は、開口部２３９（図１０）を含み、開口部２３９は、各々がストップ部材１７０のレグ１７７を受け入れることができる２つのスロット１３９の代わりに、ストップ部材２７０の両レグ２７７を受け入れるように適合される。ストップ部材２７０は、ストップ部材１７０と類似している。しかしながら、ストップ部材２７０は、第１の顎部材２３０の遠位部分２３７に直接的に接続されるストッピング部分２７４を有する。遠位部分２３７は、旋回ピン２７６を受け入れるように適合された穴２３５（図１０）を含む。旋回ピン２７６、または任意の他の適切な装置は、ストップ部材２７０を第１の顎部材２３０に旋回可能に結合する。
一般的に、第１の顎部材２３０は、湾曲した筐体２３１と湾曲したカートリッジアセンブリ２３２とを含む。筐体２３１は、湾曲したカートリッジアセンブリ２３２を受け入れるように適合された湾曲したチャンネル２３３を有する。湾曲したカートリッジアセンブリ２３２は、組織と係合するように構成された組織接触表面２３４と、その湾曲したプロフィールに沿って延びる締め具保持スロット２３６の列と、ナイフ（図示されず）をスライド可能に受け入れるように適合されたナイフチャンネル２３８とを含む。ナイフチャンネル２３８は、締め具保持スロット２３６の列の間に配置される。
上に論じられたように、作動ハンドルアセンブリ１６０は、締め具を排出するのみならず、ナイフチャンネル２３８に沿ってナイフを駆動もする（例えば、可動ハンドル１６４の単一のストロークまたは複数のストロークを介して）。ナイフチャンネル２３８は、カートリッジアセンブリ２３２の遠位部分２３７に形成された開口部２３９につながる。リセス２８０は、開口部２３９から遠位方向に位置決めされ、組織接触表面２３４に対して斜角を画定する傾斜した壁２８２（図１１を参照）を含み、その中にストップ部材２７０の一部分を受け入れるように適合される。傾斜した壁２８２に加えて、リセス２８０は、ストップ部材２７０の一部分を受け入れるように適合された空洞２８４を有する。
ストップ部材２７０は、本体２７５と、本体２７５から近位方向に延びる一対のレグと、本体２７５から横方向に延びる旋回突起２８６とを含む。レグ２７７は、ナイフを受け入れるような大きさとされたスペースをそれらの間に画定する。各レグ２７７は近位表面２７３を有し、近位表面２７３は、図９に示されるように、ストップ部材２７０が第１の位置にあるとき、組織接触表面２３４に対して斜角を画定し、図１２に示されるように、ストップ部材２７０が第２の位置にあるとき、組織接触表面２３４に対して実質的に垂直の角度を画定する。
本体２７５は、組織接触表面２３４に対して斜角を画定する。ストップ部材２７０の旋回突起２８６は、空洞２８４内に受け入れられるように適合され、旋回ピン２７６を受け入れるように構成された穴２８８を有する。旋回ピン２７６は、カートリッジアセンブリ２７０の穴２３５および旋回突起２８６の穴２８８を貫通し、ストップ部材２７０が、図９に見られるように、ストップ部材２７０の少なくとも一部分が、第１の顎部材２３０の外部に位置決めされる第１の位置から、図１２に見られるように、ストップ部材２７０の少なくとも一部分が、第１の顎部材２３０の組織接触表面２３４の少なくとも部分的に下に位置決めされる第２の位置へ旋回することを可能にする。
図１１に見られるように、本体２７６は、傾斜した壁２８２につながる通し穴２９０と、通し穴２９０に向かって突出するアバットメント壁２９２とをさらに含む。アバットメント壁２９２は、付勢部材２９４の第１の端２９４ａを保持するように構成され、傾斜した壁２８２は、付勢部材２９４の第２の端２９４ｂを支持するように適合される。付勢部材２９４は、ストップ部材２７０をその第１の位置に向けて付勢する。図１０および図１１に示された実施形態において、付勢部材２９４はバネであるが、付勢部材２９４は代替として、ストップ部材２７０を第１の顎部材２３０から遠ざかるように付勢することのできる任意の適切な装置または手段であり得る。
第１の顎部材２３０の動作は、第１の顎部材１３０の動作と実質的に同様である。第１の顎部材２３０は、アンビルアセンブリと合同で作用し、組織を切断し、かつ／または締め付ける。ユーザがハンドルアセンブリ１６０を作動させると、顎部材は接近し、これが、ストップ部材２７０を第１の位置（図９を参照）から第２の位置（図１２を参照）へ促す。第１の位置において、ストップ部材２７０の配向は、第１の顎部材２３０とアンビルアセンブリとの間に組織を導入することを容易にする。さらに、ストップ部材２７０は、ストップ部材２７０が、その第２の位置に配向されたとき、組織が、ツールアセンブリから遠位方向に逃避することを抑止する。アンビルアセンブリが、第１の顎部材２３０から遠ざかるとき、ストップ部材２７０は、付勢部材２９４の影響の下に、その第１の位置に戻る。
様々な変更が、本開示の外科用器具の実施形態に対してなされ得ることは理解される。したがって、上述は、限定するものとしてではなく、実施形態の単なる例示として理解されるべきである。当業者は、本開示の範囲および精神内で、他の変更に想到し得る。
１００ 外科用器具
１２０ 細長い部分
１２２ 近位部分
１２４ 遠位部分
１３０ 第１の顎部材
１３２ カートリッジアセンブリ
１３４ 組織接触表面
１３６ 締め具保持スロット
１４０ 第２の顎部材
１４２ アンビルアセンブリ
１５０ ツールアセンブリ
１５４ エンドエフェクタ
１６０ ハンドルアセンブリ
１６２ 固定ハンドル
１６４ 可動ハンドル
１６８ クランプバー
１７０ ストップ部材
１２０ 細長い部分
１２２ 近位部分
１２４ 遠位部分
１３０ 第１の顎部材
１３２ カートリッジアセンブリ
１３４ 組織接触表面
１３６ 締め具保持スロット
１４０ 第２の顎部材
１４２ アンビルアセンブリ
１５０ ツールアセンブリ
１５４ エンドエフェクタ
１６０ ハンドルアセンブリ
１６２ 固定ハンドル
１６４ 可動ハンドル
１６８ クランプバー
１７０ ストップ部材
Claims (15)
- 組織を外科的に接合するための外科用器具であって、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位方向に延び、長手方向軸を画定する細長い部分と、
該細長い部分の遠位部分に隣接して配置されたエンドエフェクタであって、該エンドエフェクタは、第１の顎部材と第２の顎部材とを含み、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材のかなりの部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能である、ストップ部材と
を備えている外科用器具。 - 前記カートリッジは、前記長手方向軸に対して湾曲している、請求項１に記載の外科用器具。
- 前記ストップ部材と機械的に協働するように配置された付勢部材をさらに備え、該付勢部材は、該ストップ部材をその第１の位置に向けて付勢する、請求項１に記載の外科用器具。
- 前記ストップ部材は、ベースとストッピング部分とを含み、該ベースは、該ストッピング部分と動作可能に接続されている、請求項１に記載の外科用器具。
- 前記ストッピング部分は、前記ベースと旋回可能に接続されている、請求項４に記載の外科用器具。
- 前記ストップ部材は、前記第１の顎部材に旋回可能に結合されている、請求項１に記載の外科用器具。
- 前記第１の顎部材は、ナイフチャンネルを含む、請求項１に記載の外科用器具。
- 前記ストップ部材の第１のレグおよび第２のレグをさらに備え、該第１のレグおよび該第２のレグは、前記ナイフチャンネルの相対する側に位置決めされている、請求項７に記載の外科用器具。
- 前記第１の顎部材に配置された第１のスロットおよび第２のスロットをさらに備え、該第１のスロットおよび該第２のスロットの各々は、前記第１のレグおよび前記第２のレグのうちの１つの少なくとも一部分をその中に受け入れるように適合されている、請求項８に記載の外科用器具。
- 前記第１のレグおよび前記第２のレグの各々は、前記ストップ部材が、その第２の位置に向かって動くとき、前記第１のスロットまたは前記第２のスロットを少なくとも部分的に通って動くように構成されている、請求項９に記載の外科用器具。
- 外科用器具との使用のためのツールアセンブリであって、該ツールアセンブリは、
第１の顎部材と第２の顎部材とを含むエンドエフェクタであって、少なくとも一方の顎部材は、間隔が置かれた位置と接近させられた位置との間で他方の顎部材に対して可動である、エンドエフェクタと、
該第１の顎部材の遠位部分に隣接して配置されたストップ部材であって、該ストップ部材は、該ストップ部材の少なくとも一部分が該第１の顎部材の外部に位置決めされる第１の位置と、該第１の顎部材と該第２の顎部材との間で組織を捕捉する第２の位置との間で、該第１の顎部材に対して旋回可能であり、該接近させられた位置に向かう該顎部材の相対的な動きは、該ストップ部材の少なくとも一部分を該第１の顎部材に向かって動かす、ストップ部材と
を備えている、ツールアセンブリ。 - 前記エンドエフェクタは、長手方向に曲線をなす形状を含む、請求項１１に記載のツールアセンブリ。
- 前記ストップ部材は、前記第１の位置に向かって付勢される、請求項１１に記載のツールアセンブリ。
- 前記第１の顎部材は、そこに形成された少なくとも１つのスロットを含み、該少なくとも１つのスロットは、前記ストップ部材の少なくとも一部分を受け入れるように構成されている、請求項１１に記載のツールアセンブリ。
- 外科用締め具によって組織を締め付けるためのシステムであって、該システムは、
第１の顎部材および第２の顎部材であって、該第１の顎部材および該第２の顎部材は、それらの間に組織を配置するように構成され、該第１の顎部材は、組織を係合するため、該第２の顎部材に対して旋回されるように構成されている、第１の顎部材および第２の顎部材と、
該第１の顎部材と該第２の顎部材との間に配置されたストップ部材であって、該第１の顎部材と該第２の顎部材との間に組織を維持するため、旋回されるように構成され、該顎の遠位端に配置されている、ストップ部材と
を備えている、システム。
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|---|---|---|---|
| US12/235,751 US7896214B2 (en) | 2008-09-23 | 2008-09-23 | Tissue stop for surgical instrument |
| US12/235,751 | 2008-09-23 |
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| JP2013226695A Expired - Fee Related JP5841116B2 (ja) | 2008-09-23 | 2013-10-31 | 外科用器具のための組織止め |
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| JP2012075868A (ja) * | 2010-10-01 | 2012-04-19 | Tyco Healthcare Group Lp | 外科手術器具のための組織停止部 |
| US9901339B2 (en) | 2010-10-01 | 2018-02-27 | Covidien Lp | Tissue stop for surgical instrument |
| US10499910B2 (en) | 2010-10-01 | 2019-12-10 | Covidien Lp | Tissue stop for surgical instrument |
| US11375998B2 (en) | 2010-10-01 | 2022-07-05 | Covidien Lp | Tissue stop for surgical instrument |
| JP2012110674A (ja) * | 2010-11-23 | 2012-06-14 | Tyco Healthcare Group Lp | 外科用器具のための組織停止部 |
| US11534163B2 (en) | 2019-11-21 | 2022-12-27 | Covidien Lp | Surgical stapling instruments |
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| ES2398082T3 (es) | 2013-03-13 |
| CA2676307C (en) | 2017-03-21 |
| CN103690214B (zh) | 2016-01-20 |
| US20110163150A1 (en) | 2011-07-07 |
| ES2377594T3 (es) | 2012-03-29 |
| EP2165662B1 (en) | 2011-12-07 |
| JP5841116B2 (ja) | 2016-01-13 |
| ATE536138T1 (de) | 2011-12-15 |
| JP2015157191A (ja) | 2015-09-03 |
| AU2009210413A1 (en) | 2010-04-08 |
| EP2389876B1 (en) | 2012-12-26 |
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| CN101683282A (zh) | 2010-03-31 |
| US9295465B2 (en) | 2016-03-29 |
| AU2009210413B2 (en) | 2013-09-12 |
| US20110114702A1 (en) | 2011-05-19 |
| JP5480571B2 (ja) | 2014-04-23 |
| CA2676307A1 (en) | 2010-03-23 |
| CN101683282B (zh) | 2014-04-16 |
| US20130087601A1 (en) | 2013-04-11 |
| JP2014061403A (ja) | 2014-04-10 |
| US8740039B2 (en) | 2014-06-03 |
| US8746534B2 (en) | 2014-06-10 |
| US20100072257A1 (en) | 2010-03-25 |
| EP2165662A1 (en) | 2010-03-24 |
| CN103690214A (zh) | 2014-04-02 |
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