JP2010131404A - 組織を固定するための装置および方法 - Google Patents
組織を固定するための装置および方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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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
- A61B17/064—Surgical staples, i.e. penetrating the 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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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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
- A61B17/0682—Surgical staplers, e.g. containing multiple staples or clamps for applying U-shaped staples or clamps, e.g. without a forming anvil
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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
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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
- A61B2017/00243—Type of minimally invasive operation cardiac
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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
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
- A61B2017/00783—Valvuloplasty
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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
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/044—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws
- A61B2017/0443—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors with a threaded shaft, e.g. screws the shaft being resilient and having a coiled or helical shape in the released state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
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Abstract
【解決手段】アンカー、アンカーシステム、アンカー送達装置、およびアンカーの使用方法を説明する。アンカー600は、2つの湾曲した脚602が単一の巻き方向で交差してループを形成し、これらの脚が組織に貫入するようになっている可撓性アンカーであってもよい。これらの湾曲した脚の両端部612、614は、鈍くても鋭くてもよい。アンカーは、展張形態および送達形態など複数の異なる形態を取ることができ、さらにこれらの複数の形態間で切り替わるようにしてもよい。動作時、アンカーが展張形態に自己拡張するように組織中に挿入されると、アンカーは送達形態から解放されて、アンカーの両脚が湾曲した経路で組織に貫入しうる。
【選択図】図14
Description
特許文献1には、動脈の修復のための装置が記載されている。注目される他の米国特許として、特許文献2、特許文献3、特許文献4、特許文献5、特許文献6、特許文献7、特許文献8、特許文献9、特許文献10、特許文献11、および特許文献12が挙げられる。注目される他の米国特許出願として、特許文献13、および特許文献14が挙げられる。上記の特許および出願のすべてを、参照によって本願に援用するものとする。
(項目1)
可撓性アンカーであって、
単一の巻き方向で交差することによりループを形成する2つの湾曲した脚を備えており、該脚が組織に貫入するように構成されている、可撓性アンカー。
(項目2)
前記湾曲した脚の端部が鈍い、項目1に記載のアンカー。
(項目3)
前記湾曲した脚の端部が鋭い、項目1に記載のアンカー。
(項目4)
前記アンカーが形状記憶材料で作られている、項目1に記載のアンカー。
(項目5)
前記アンカーがニッケル−チタン合金を含む、項目4に記載のアンカー。
(項目6)
前記アンカーが超弾性材料で作られている、項目1に記載のアンカー。
(項目7)
前記脚が折り畳まれる送達形態と、該脚が拡張される展張形態とを有する、項目1に記載のアンカー。
(項目8)
前記展開形態における前記脚の間の最大間隔に対する前記送達形態における該脚の端部の間の最大間隔の比が、約1:2から約1:20である、項目7に記載のアンカー。
(項目9)
前記アンカーが組織に挿入されるときに、該アンカーは該組織の動的負荷の間にエネルギーを吸収することにより該組織におけるピーク応力を軽減する、項目1に記載のアンカー。
(項目10)
前記アンカーの弾性は、該アンカーの挿入されるべき前記組織の弾性と調和する、項目1に記載のアンカー。
(項目11)
前記アンカーが組織内で展張されるとき、該組織の動的負荷の間にエネルギーを吸収するために、該アンカーは前記展張形態から拡張または折り畳み得る、項目1に記載のアンカー。
(項目12)
前記ループの少なくとも一部は、前記脚より撓みにくいループサイズ制限領域を含む、項目1に記載のアンカー。
(項目13)
展張形態を有し、単一の巻き方向で交差することによりループを形成する2つの脚を備える、組織に挿入する可撓性アンカーであって、該アンカーが組織に挿入されると、該展張形態からの折り畳みまたは拡張によって該組織の反復負荷の間のエネルギーを該アンカーが吸収することにより、該組織におけるピーク応力を軽減する、アンカー。
(項目14)
前記脚が折り畳まれる送達形態を有する、項目13に記載のアンカー。
(項目15)
前記前記アンカーの脚の端部が湾曲した経路で組織に貫入する、項目13に記載のアンカー。
(項目16)
前記アンカーの脚の端部は、組織のかたよりを最小化する対抗方向に組織を貫入する、項目13に記載のアンカー。
(項目17)
前記アンカーを組織内に展張するために前記脚の端部が拡張されると、該脚の端部の該拡張によって該アンカーが該組織内に打ち込まれる、項目13に記載のアンカー。
(項目18)
前記アンカーは、形状記憶材料で作られている、項目13に記載のアンカー。
(項目19)
前記アンカーは、ニッケルチタン合金を含む、項目13に記載のアンカー。
(項目20)
前記展開形態における前記脚の間の間隔に対する前記送達形態における該脚の間の間隔の比が、約1:2から約1:20である、項目14に記載のアンカー。
(項目21)
前記アンカーの弾性は、該アンカーが挿入されべき前記組織の弾性に調和する、項目13に記載のアンカー。
(項目22)
可撓性アンカーであって、
単一の巻き方向で交差することによりループを形成する2つの湾曲した脚を備えており、該脚は、組織内への展張方向と実質的に平行に向けられながら組織に貫入するように構成されている、可撓性アンカー。
アンカーは、何れか適切なファスナーでもよい。具体的には、アンカーは、単一の巻き方向で交差してループを形成する2つの湾曲した脚を有し、これらの脚が組織に貫入するようになっている可撓性アンカーでもよい。図14は、本明細書に記載のアンカーの一例を示す。図14において、アンカー600は、湾曲した脚601、602とループ領域605とを有する。これらの脚およびループ領域はすべて矢印610で示される単一の巻き方向を有する。
本明細書に記載のアンカーは、全般的には可撓性のアンカーであり、展張形態と1つ以上の圧縮または拡張形態との間で移行しうる。展張形態は、弛緩形態とも称される。上記のように、送達形態は圧縮された形態(図15Bに示すような形態)でも、拡張された形態(図4および図5に示すような形態)でもよい。アンカーはさまざまな圧縮量または拡張量で圧縮または拡張しうるので、多くの拡張形態または圧縮形態が存在しうる。
び結晶性オリゴ(r−ジオキサノン)ジオールなどの形状記憶ポリマー、等)を含んでも
よい。
本明細書に記載のアンカーは、何れか適切な処置の一部として使用しうる。上記のように、心臓弁輪の治療は、本明細書に記載のアンカーの恩恵を受けうる処置の一例にすぎない。通常、本明細書に記載の可撓性組織アンカーは、組織と組織とを接続するため、またはインプラントまたは移植片を組織に接続するため、または移植片と移植片とを接続するため、または組織の形状を変えるためのアンカーシステムを形成するために、使用しうる。
上記のように、以下の実施例は、心臓弁輪の治療のためのアンカーの使用法を説明する。これらの実施例は、アンカー、アンカー送達装置、アンカーシステム、およびアンカー使用方法の可能な一用途を例示することを意図しており、限定するものとは見なされないものとする。
Claims (1)
- 明細書中に記載の方法。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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US11/202,474 US20050273138A1 (en) | 2003-12-19 | 2005-08-11 | Devices and methods for anchoring tissue |
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JP2008526192A Division JP2009504263A (ja) | 2005-08-11 | 2006-08-10 | 組織を固定するための装置および方法 |
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JP2008526192A Pending JP2009504263A (ja) | 2005-08-11 | 2006-08-10 | 組織を固定するための装置および方法 |
JP2009296093A Pending JP2010131404A (ja) | 2005-08-11 | 2009-12-25 | 組織を固定するための装置および方法 |
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Country | Link |
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US (7) | US20050273138A1 (ja) |
EP (1) | EP1919369A1 (ja) |
JP (2) | JP2009504263A (ja) |
AU (1) | AU2006279938A1 (ja) |
CA (1) | CA2618500A1 (ja) |
IL (1) | IL188965A0 (ja) |
WO (1) | WO2007021834A1 (ja) |
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JP2015524707A (ja) * | 2012-08-10 | 2015-08-27 | ダブリュ.エル.ゴア アンド アソシエイツ,インコーポレイティドW.L. Gore & Associates, Incorporated | 器具を体組織に固定するためのマイクロアンカー |
JP2019084353A (ja) * | 2017-05-05 | 2019-06-06 | コヴィディエン リミテッド パートナーシップ | 拡大可能なバックスパンを備えた外科用ステープル |
WO2021251650A1 (ko) * | 2020-06-09 | 2021-12-16 | 울산대학교 산학협력단 | 내강 접합 장치 |
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- 2006-08-10 CA CA002618500A patent/CA2618500A1/en not_active Abandoned
- 2006-08-10 AU AU2006279938A patent/AU2006279938A1/en not_active Abandoned
- 2006-08-10 EP EP06801136A patent/EP1919369A1/en not_active Withdrawn
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2007
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-
2008
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-
2009
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2012
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JP2015524707A (ja) * | 2012-08-10 | 2015-08-27 | ダブリュ.エル.ゴア アンド アソシエイツ,インコーポレイティドW.L. Gore & Associates, Incorporated | 器具を体組織に固定するためのマイクロアンカー |
JP2016179189A (ja) * | 2012-08-10 | 2016-10-13 | ダブリュ.エル.ゴア アンド アソシエイツ,インコーポレイティドW.L. Gore & Associates, Incorporated | 器具を体組織に固定するためのマイクロアンカー |
JP2017047230A (ja) * | 2012-08-10 | 2017-03-09 | ダブリュ.エル.ゴア アンド アソシエイツ,インコーポレイティドW.L. Gore & Associates, Incorporated | 器具を体組織に固定するためのマイクロアンカー |
KR101752576B1 (ko) * | 2012-08-10 | 2017-06-29 | 더블유.엘. 고어 앤드 어소시에이트스, 인코포레이티드 | 체조직에 기구를 고정시키기 위한 마이크로앵커 |
JP2019084353A (ja) * | 2017-05-05 | 2019-06-06 | コヴィディエン リミテッド パートナーシップ | 拡大可能なバックスパンを備えた外科用ステープル |
JP7370135B2 (ja) | 2017-05-05 | 2023-10-27 | コヴィディエン リミテッド パートナーシップ | 拡大可能なバックスパンを備えた外科用ステープル |
WO2021251650A1 (ko) * | 2020-06-09 | 2021-12-16 | 울산대학교 산학협력단 | 내강 접합 장치 |
Also Published As
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JP2009504263A (ja) | 2009-02-05 |
US20080051832A1 (en) | 2008-02-28 |
EP1919369A1 (en) | 2008-05-14 |
US20080045982A1 (en) | 2008-02-21 |
US20080045983A1 (en) | 2008-02-21 |
US20050273138A1 (en) | 2005-12-08 |
US20120271331A1 (en) | 2012-10-25 |
CA2618500A1 (en) | 2007-02-22 |
US20080051810A1 (en) | 2008-02-28 |
WO2007021834A1 (en) | 2007-02-22 |
IL188965A0 (en) | 2008-08-07 |
AU2006279938A1 (en) | 2007-02-22 |
US20080058868A1 (en) | 2008-03-06 |
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