JP2011045746A - 切断機構付きの開放手術用血管密封器械 - Google Patents
切断機構付きの開放手術用血管密封器械 Download PDFInfo
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- A61B17/28—Surgical forceps
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- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
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- 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
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
Abstract
【解決手段】開放手術用電気外科鉗子(10)は、組織を離したり掴むよう動くことができるジョー部材(62,64)を備えた1対のシャフト部材(12,20)を有する。ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える導電性密封プレート(68,68)を有する。ジョー部材の少なくとも一方に設けられた切断スロットを通って切断器械を近位側の第1の位置から遠位側の少なくとも1つの次の位置に選択的に前進させるアクチュエータ(40)が設けられている。アクチュエータは、ジョー部材相互間に保持されている組織を通って前記切断器械を第1の位置から第2の位置に前進させるようプーリ及びケーブルシステムと協働するトリガ組立体を有する。
【選択図】図1A
Description
好ましくは、鉗子は、ジョー部材が第1の位置にあるとき、切断器械の往復動を阻止する安全機構又はロックアウトを有している。ロックアウトは、トリガ組立体の一部をなすと共に(或いは)ジョー部材のうちの一方又は両方の一部をなすのがよい。
今、図1A〜図1Eを参照すると、開放外科手術手技に用いられる鉗子10が、各々が近位端部14,24及び遠位端部16,26をそれぞれ備えた細長いシャフト部分12,20を有している。図面及び以下の説明において、「近位」という用語は、従来通り使用されており、ユーザの最も近くに位置する鉗子10の端部を意味し、「遠位」という用語は、ユーザから見て遠くに位置する鉗子10の端部を意味する。
好ましくは、絶縁外側ハウジング63及び導電性密封面67は、組織の密封と関連した公知の望ましくない効果、例えば、フラッシュオーバ、熱的広がり及び迷走電流の散逸のうち多くを制限すると共に(或いは)減少させるよう寸法決めされている。上述の製造法及び引照した製造法は全て、絶縁外側ハウジング63によって実質的に包囲された導電性表面67を有する電極をもたらす。
図1C及び図1Dで最もよく分かるように、ジョー部材62,64は、これら相互間に位置したナイフチャネル69を有し、このナイフチャネルは、これと共に切断機構60の往復動を可能にするよう構成されている。ナイフチャネルの一例は、共通所有者の米国特許出願第10/284,562号明細書に開示されており、この米国特許出願明細書の開示内容全体を本明細書の一部を形成するものとしてここに引用する。好ましくは、ナイフチャネル60全体を、2つの対向したチャネル半部69a,69bが組織の掴み時に結合した際に形成される。ナイフチャネル69をテーパさせるのがよく、又は遠位側方向への切断機構90の往復動中組織の切断を容易にし又は促進する他の或る形態のものであるのがよいことが考えられる。さらに、ナイフチャネル69は、ジョー部材62,64が組織の周りで閉鎖されるまで切断機構90が組織を通って前進するのを阻止する1以上の安全特徴を備えるのがよい。
図4は、ジョー部材462,464相互間に掴まれた組織を貫通して切断機構90を前進させるよう設計されたレバー状アクチュエータ440を有する本発明の更に別の実施形態としての鉗子400を示している。より詳細に説明すると、作動機構440は、ユーザにより作動可能に位置決めされ、第1のリンク444の近位端部に連結されたフィンガタブ442を有している。リンク444は、その遠位端部がピボットレバー445の一端部に連結されている。ピボットレバー445は、その反対側の端部が第2のリンク446に連結され、この第2のリンクは、切断機構90に連結されている。
〔態様1〕組織を密封するための開放手術用電気外科鉗子であって、各々がその遠位端部に配置されたジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置から、前記ジョー部材が協働してこれらの間で組織を掴む少なくとも1つの次の位置に移動することができ、前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える導電性密封プレートを有し、前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるように寸法形状決めされ、前記切断器械を、前記切断器械が前記ジョー部材相互間に保持された組織に対して近位側に位置する第1の位置から、前記切断器械が前記ジョー部材相互間に保持された組織に対して遠位側に位置する少なくとも1つの次の位置に、選択的に前進させるアクチュエータを有し、前記アクチュエータは、前記ジョー部材相互間に保持されている組織を通って前記切断器械を前記第1の位置から前記第2の位置に前進させるようにプーリ及びケーブルシステムと協働するトリガ組立体を有する、組織を密封するための開放手術用電気外科鉗子。
〔態様2〕前記アクチュエータの前記トリガ組立体は、前記切断スロットを通って前記切断器械を遠位側へ前進させるよう近位側へ引っ張られる、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様3〕前記アクチュエータの前記トリガ組立体は、前記切断スロットを通って前記切断器械を遠位側へ前進させるよう遠位側へ押される、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様4〕前記アクチュエータの前記トリガ組立体は、前記切断スロットを通って前記切断器械を遠位側へ前進させるよう側方へ動かされる、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様5〕前記ジョー部材が第1の位置にあるとき、前記切断器械の往復動を阻止するロックアウトを更に有している、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様6〕前記ロックアウトは、トリガ組立体の一部をなす、上記態様5記載の組織を密封するための開放手術用電気外科鉗子。
〔態様7〕前記ロックアウトは、前記ジョー部材の少なくとも一方の一部をなす、上記態様5記載の組織を密封するための開放手術用電気外科鉗子。
〔態様8〕前記ロックアウトは、前記切断器械の一部をなす、上記態様7記載の組織を密封するための開放手術用電気外科鉗子。
〔態様9〕前記ロックアウトは、少なくとも一方のジョー部材の一部をなす、上記態様5記載の組織を密封するための開放手術用電気外科鉗子。
〔態様10〕前記ロックアウトは、前記第1及び第2のシャフトのうちの少なくとも一方の一部をなす、上記態様5記載の組織を密封するための開放手術用電気外科鉗子。
〔態様11〕前記シャフトは各々、取っ手を有し、前記取っ手のうち少なくとも1つには前記プーリ及びケーブルシステムのケーブルを往復動させる軌道が貫通して形成され、前記ケーブルは、前記切断器械と機械的に係合して前記ケーブルの運動により第1の位置と次の位置との間における前記切断機構の運動が行われるようになっている、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様12〕前記ケーブルは、前記軌道内でのケーブルの座屈を阻止する少なくとも1つの補剛材を有している、上記態様11記載の組織を密封するための開放手術用電気外科鉗子。
〔態様13〕前記ケーブルは、編組柔軟ケーブルである、上記態様11記載の組織を密封するための開放手術用電気外科鉗子。
〔態様14〕前記ケーブルは、プラスチック材料で作られている、上記態様11記載の組織を密封するための開放手術用電気外科鉗子。
〔態様15〕前記切断器械を前記第1の位置に自動的に付勢する少なくとも1つのばねを更に有している、上記態様1記載の組織を密封するための開放手術用電気外科鉗子。
〔態様16〕前記トリガ組立体は、前記切断器械を前記第1の位置に自動的に戻す前記少なくとも1つのばねを有している、上記態様15記載の組織を密封するための開放手術用電気外科鉗子。
〔態様17〕組織を密封するための開放手術用電気外科鉗子であって、各々がその遠位端部に位置するジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置からジョー部材が協働してこれらの間に組織を掴む少なくとも1つの次の位置に動くことができ、前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える導電性密封プレートを有し、前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるよう寸法決めされており、切断器械を前記切断器械が前記ジョー部材相互間に保持された組織に対して近位側に位置する第1の位置から前記切断器械が前記ジョー部材相互間に保持された組織に対して遠位側に位置する少なくとも1つの次の位置に選択的に前進させるアクチュエータを有し、前記アクチュエータは、ジョー部材相互間に保持されている組織を通って前記切断器械を第1の位置から第2の位置に前進させるようラックピニオンシステムと協働するトリガ組立体を有している、組織を密封するための開放手術用電気外科鉗子。
〔態様18〕前記ラックピニオンシステムは、第1及び第2のシャフト部材のうちの一方と係合する、上記態様17記載の組織を密封するための開放手術用電気外科鉗子。
〔態様19〕前記アクチュエータの前記トリガ組立体は、前記切断スロットを通って前記切断器械を遠位側へ前進させるよう近位側へ引っ張られる、上記態様17記載の組織を密封するための開放手術用電気外科鉗子。
〔態様20〕前記アクチュエータの前記トリガ組立体は、前記切断スロットを通って前記切断器械を前進させるよう遠位側へ押される、上記態様17記載の組織を密封するための開放手術用電気外科鉗子。
〔態様21〕組織を密封する開放手術用電気外科鉗子であって、各々がその遠位端部に位置するジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置からジョー部材が協働してこれらの間に組織を掴む少なくとも1つの次の位置に動くことができ、前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝えるよう電気外科エネルギ源に接続されるようになった導電性密封プレートを有し、前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるよう寸法決めされており、切断器械を前記切断器械が前記ジョー部材相互間に保持された組織に対して近位側に位置する第1の位置から前記切断器械が前記ジョー部材相互間に保持された組織に対して遠位側に位置する少なくとも1つの次の位置に選択的に前進させるアクチュエータを有し、前記アクチュエータは、ジョー部材相互間に保持されている組織を通って前記切断器械を第1の位置から第2の位置に前進させるようラックピニオンシステムと協働するトリガ組立体を有し、前記ラックピニオンシステムは、切断器械を切断スロット内の最も近位側の位置に付勢する付勢部材を有している、組織を密封するための開放手術用電気外科鉗子。
〔態様22〕前記付勢部材は、ばねである、上記態様21記載の組織を密封するための開放手術用電気外科鉗子。
〔態様23〕第1及び第2のシャフト部材のうちの一方に設けられていて、ユーザが鉗子を選択的に作動させて組織を密封することができるようにするハンドスイッチを更に有している、上記態様21記載の組織を密封するための開放手術用電気外科鉗子。
Claims (8)
- 組織を密封するための開放手術用電気外科鉗子であって、
各々がその遠位端部に位置するジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置からジョー部材が協働してこれらの間に組織を掴む少なくとも1つの次の位置に動くことができ、前記第1及び第2のシャフト部材の一方は、フランジを有し、このフランジは、前記シャフト部材の他方に形成された開口部と位置合わせされ、
前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える導電性密封プレートを有し、
前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるよう寸法決めされており、
更に、前記ジョー部材の間に配置された組織を切断するように前記切断器械を選択的に往復動させるアクチュエータを有し、
更に、前記ジョー部材が第1の位置にあるとき、前記切断器械の往復動を阻止するように、前記シャフト部材の他方に形成された開口部内に付勢されるばねを備えたロックアウトを有し、前記ばねは、前記ジョー部材が第2の位置に移動されたとき、前記フランジによる係合が解除されることを特徴とする組織を密封するための開放手術用電気外科鉗子。 - 前記フランジは、前記ジョー部材が第2の位置に移動されたとき、前記切断器械の安全バーの往復動を可能にするように形成された孔を備えている請求項1記載の組織を密封するための開放手術用電気外科鉗子。
- 前記ロックアウトは、前記鉗子の近位端部に配置されている請求項1記載の組織を密封するための開放手術用電気外科鉗子。
- 前記ばねは、このばねと対応するシャフト部材に形成されたチャンバ内に入れられて係合が解除される請求項1記載の組織を密封するための開放手術用電気外科鉗子。
- 組織を密封するための開放手術用電気外科鉗子であって、
各々がその遠位端部に位置するジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置からジョー部材が協働してこれらの間に組織を掴む少なくとも1つの次の位置にピボット回りに動くことができ、
前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える導電性密封プレートを有し、
前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるよう寸法決めされており、
更に、前記ジョー部材の間に配置された組織を切断するように前記切断器械を選択的に往復動させるアクチュエータを有し、
更に、前記切断器械の一部分に形成された切欠きを備えたロックアウトを有し、前記切欠きは、前記ジョー部材が第1の位置にあるとき、前記切断器械の往復動を阻止するように、前記ピボットの戻止めに係合し、前記切欠きは、前記ジョー部材が前記切断器械の選択的な往復動を可能にする第2の位置に移動されたとき、前記戻止めから自動的に係合が解除されることを特徴とする組織を密封するための開放手術用電気外科鉗子。 - 前記切欠きは、前記切断器械の駆動ロッドに形成されている請求項5記載の組織を密封するための開放手術用電気外科鉗子。
- 組織を密封するための開放手術用電気外科鉗子であって、
各々がその遠位端部に位置するジョー部材を備えた1対の第1及び第2のシャフト部材を有し、前記ジョー部材は、互いに対して間隔を置いた関係にある第1の位置からジョー部材が協働してこれらの間に組織を掴む少なくとも1つの次の位置にピボット回りに動くことができ、前記ジョー部材の各々が、前記シャフト部材を貫くように定められた長手方向軸線に対して湾曲しており、
前記ジョー部材は各々、これらの間に保持されている組織を通って電気外科エネルギを伝える湾曲した導電性密封プレートを有し、
前記ジョー部材のうちの少なくとも一方は、その長さに沿って形成された切断スロットを有し、前記切断スロットは、これに沿って切断器械を往復動させるよう寸法決めされており、
更に、前記ジョー部材の間に配置された組織を切断するように前記切断器械を選択的に往復動させるアクチュエータを有し、
更に、前記ジョー部材が第1の位置にあるとき、前記切断器械の往復動を阻止するように、前記切断器械に結合されることを特徴とする組織を密封するための開放手術用電気外科鉗子。 - 前記切断器械は、前記切断スロットを通過する前記切断器械の往復動を容易にするように可撓性を備えている請求項7記載の組織を密封するための開放手術用電気外科鉗子。
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JPH0930945A (ja) * | 1995-07-21 | 1997-02-04 | Shiseido Co Ltd | 皮膚外用剤 |
JP2003245285A (ja) * | 2002-01-23 | 2003-09-02 | Ethicon Endo Surgery Inc | 電気外科機器用フィードバック灯装置および方法 |
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KR101629269B1 (ko) * | 2014-10-07 | 2016-06-10 | 김남복 | 안면골 절단장치 |
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Also Published As
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US20110238067A1 (en) | 2011-09-29 |
CA2487914A1 (en) | 2005-05-19 |
EP2942026A1 (en) | 2015-11-11 |
EP1532932A1 (en) | 2005-05-25 |
AU2010224379A1 (en) | 2010-10-14 |
US20050119655A1 (en) | 2005-06-02 |
US7131970B2 (en) | 2006-11-07 |
AU2004231212B2 (en) | 2010-06-24 |
JP5214706B2 (ja) | 2013-06-19 |
US20070088356A1 (en) | 2007-04-19 |
JP5237521B2 (ja) | 2013-07-17 |
EP1532932B1 (en) | 2015-09-09 |
US8394096B2 (en) | 2013-03-12 |
JP2005144193A (ja) | 2005-06-09 |
EP2942026B1 (en) | 2018-09-12 |
AU2004231212A1 (en) | 2005-06-02 |
US7922718B2 (en) | 2011-04-12 |
CA2487914C (en) | 2013-10-08 |
AU2010224379B2 (en) | 2013-07-04 |
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