JP2011509121A - 内視鏡を使用して穴を縫合するための医療装置、器具及び方法 - Google Patents
内視鏡を使用して穴を縫合するための医療装置、器具及び方法 Download PDFInfo
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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
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
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- A—HUMAN NECESSITIES
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- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/062—Needle manipulators
- A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
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- A—HUMAN NECESSITIES
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
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- A—HUMAN NECESSITIES
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- A—HUMAN NECESSITIES
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
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- A61B17/06066—Needles, e.g. needle tip configurations
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Abstract
Description
12 組織、
14 穴、
20 医療装置、
22 内視鏡、
23 作動通路、ガイド通路
24 医療器具、
26 エンドキャップ、
28 針、
30 遠位の把持装置、上方把持装置、把持装置、第一の把持装置
32 近位の把持装置、下方の把持装置、把持装置、第二の把持装置
34 縫合領域、縫合空間、
36 縫合糸、
38 管状本体、
40 内部空洞、
42 第一のガイド本体、
44 第二のガイド本体、
48 遠位のガイドフランジ、
50 近位のガイドフランジ、
52 補強リブ、
54 通路、
56 通路、
58 支持アーム、
60 ガイドフランジ、
62 ガイド穴、
70 把持アーム、
72 把持プレート、
72R 把持プレート72の右半分、
72L 把持プレート72の左半分、
74 制御ワイヤー、
76 結合プレート、
78 シース、
80 ガイドロッド、
82 把持ブラケット、
84 すり割り、
86 把持ブラケット82の自由端、
88 ガイド穴、
90 一対の取付け穴、
92 取り付け穴、
94 把持穴、
96 スリット、
100 針の細長い本体、細長い本体、針本体、針、ニードル28の本体
102 本体100の第一の端部、
104 本体100の反対側の端部、
106 環状の切り込み、第一の切り込み、切り込み
108 第二の切り込み、第二の環状の切り込み、溝
110 コレット、
112 制御ワイヤー、
114 カテーテル、
116 基部、
118 把持用指状部、
120 内部空間、
122 把持用指状部118の遠位端、
124 歯、
200 針本体、
202 針本体の第一の端部、
204 針本体の第二の端部、
206 第一の環状リブ、第一のリブ
208 第二の環状リブ、
370 把持アーム、
372R、372L、 把持ワイヤー、ワイヤー
372 すり割り、
432 下方の把持装置、近位の把持装置、
418 把持用指状部、第二の把持用指状部
420 内部空間、
422 制御ワイヤー、
424 枢軸、
520 医療装置、
522 内視鏡、
524 医療器具、
526 エンドキャップ、
530 遠位の把持装置、
532 近位の把持装置、
542 第一の支持本体、
544 第二の支持本体、第二の支持構造、
562 ガイド穴、
570 L字形状のアーム、
582 把持ブラケット、
584 把持プレート、
630 遠位の把持装置、
670 把持アーム、
682 把持ブラケット、
684 すり割り、
688 ガイド穴、
730 遠位の把持装置、
770 把持アーム、
782 把持ブラケット、
784 第一の結合部、
786 第二の湾曲した部分、
788 第三の端部
Claims (20)
- 組織の穴を縫合するための医療装置であり、
作動通路を有し且つ長手軸線を規定している内視鏡と、
前記内視鏡の遠位端に嵌合されているエンドキャップと、
第一の端部と該第一の端部と反対側の第二の端部とを有している針と、
前記針に取り付けられた縫合糸と、
長手方向に並進するために前記エンドキャップに長手方向に摺動可能に結合されており且つ前記針と選択的に係合する構造とされている第一の把持装置と、
前記針と選択的に係合する構造とされ且つ長手方向に並進するために前記エンドキャップと前記内視鏡の前記作動通路のうちの一つの中を摺動可能に貫通している第二の把持装置と、を備えており、
前記第一の把持装置と第二の把持装置とは、前記針を、前記第一の把持装置と第二の把持装置との間を選択的に通すために相対的に長手方向に並進する構造とされている、医療装置。 - 前記第二の把持装置が、前記内視鏡の前記作動通路の中を貫通している制御部材を備えている、請求項1に記載の医療装置。
- 前記第二の把持装置が、調整可能な把持力を有している、請求項1に記載の医療装置。
- 前記第一の把持装置が、調整不可能な把持力を有している、請求項3に記載の医療装置。
- 前記第一の把持装置が、本来の状態が前記針と係合する大きさである調整可能な開口部を備えている、請求項4に記載の医療装置。
- 前記針が、前記第一の端部の近くに第一の切り込みを備えており、前記開口部の前記本来の状態が、前記第一の切り込みの近くで前記針を受け入れる大きさとされている、請求項5に記載の医療装置。
- 前記第二の把持装置が、本来の状態が前記針と係合する大きさである調整可能な開口部を備えている、請求項1に記載の医療装置。
- 前記第二の把持装置が、前記調整可能な開口部の大きさを小さくするように手動によって調整できる、請求項7に記載の医療装置。
- 前記第二の把持装置が、前記第一の把持装置から長手方向に隔てられており且つ前記第一の把持装置と径方向に整列されている、請求項1に記載の医療装置。
- 組識を縫合するために内視鏡と共に使用するための医療器具であり、
前記内視鏡の遠位端を受け入れる大きさとされている内部空間を規定しているエンドキャップと、
第一の端部と、該第一の端部と反対側の第二の端部とを備えている針と、
前記針に取り付けられた縫合糸と、
所定の第一の把持力によって前記針に選択的に係合する構造とされている第一の把持装置と、
前記第一の把持装置から長手方向に隔てられており且つ第二の把持力によって前記針と選択的に係合する構造とされている、第二の把持装置と、を備えており、
前記第二の把持装置は、前記第二の把持力を、第一の強さと第二の強さとの間で修正する調整可能な把持力を有しており、
前記第一の把持装置と第二の把持装置とは、前記針を、前記第一の把持装置と第二の把持装置との間を選択的に通すように相対的に並進できる構造とされている、医療器具。 - 前記第二の把持力の前記第一の強さが前記第一の把持力よりも弱く、前記第二の把持力の前記第二の強さが前記第一の把持力よりも強い、請求項10に記載の医療器具。
- 前記第一の把持装置が調整可能な開口部を規定しているプレートである、請求項10に記載の医療器具。
- 前記第一の把持装置が、間に調整可能な空間を規定している一対のワイヤーである、請求項10に記載の医療器具。
- 前記第二の把持装置が指状部を備えているコレットである、請求項10に記載の医療器具。
- 前記第二の把持装置がカテーテルを備えており、カテーテルとコレットとの間の相対的な並進によって、前記第二の把持力が、前記第一の強さと第二の強さとの間で調整されるようになされた、請求項14に記載の医療器具。
- 前記第二の把持装置が鉗子からなる、請求項10に記載の医療器具。
- 前記第一の把持装置が、エンドキャップの外側部分に摺動可能に取り付けられているL字形状の把持アームを備えている、請求項10に記載の医療装置。
- 前記L字形状の把持アームが、前記針をガイドするための切頭円錐形状の開口部を備えている、請求項10に記載の医療装置。
- 前記エンドキャップが前記第二の把持装置のための支持アームを備えており、該支持アームは、前記第二の把持装置の把持部材と整列されているガイド穴を備えている、請求項10に記載の医療器具。
- 針を通す方法であり、
作動通路を備えている内視鏡を準備するステップと、
エンドキャップ、針、縫合糸、第一の把持装置及び第二の把持装置を備えている医療器具を準備するステップであり、前記エンドキャップは前記内視鏡の遠位端を受け入れる大きさとされた内部空間を規定しており、前記針は、第一の端部と、該第一の端部と反対側の第二の端部を有しており、前記縫合糸は前記針に取り付けられており、前記第一の把持装置は第一の把持力によって前記針と選択的に係合する構造とされており、前記第二の把持装置は、前記第一の把持装置から長手方向に隔てられており且つ第二の把持力によって前記針と選択的に係合する構造とされており、前記第一の把持装置と第二の把持装置とは、前記針を該第一の把持装置と第二の把持装置との間を選択的に通すために相対的に並進する構造とされている、医療器具を準備するステップと、
前記針を前記第一の把持装置内に位置決めするステップと、
前記第一及び第二の把持装置を互いに相対的に並進させて、前記針を前記第二の把持装置内に位置決めするステップと、
前記第二の把持装置の前記把持力を、前記第一の把持力よりも大きくなるように調整するステップと、
前記第一及び第二の把持装置を互いに相対的に並進させて、前記針を前記第一の把持装置から前記第二の把持装置へと通すステップと、
前記第二の把持装置の前記把持力を前記第一の把持力よりも小さくなるように調整するステップと、
前記第一及び第二の把持装置を互いに相対的に並進させて、前記針を前記第二の把持装置から前記第一の把持装置へと通すステップと、を含む方法。
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US1878608P | 2008-01-03 | 2008-01-03 | |
US61/018,786 | 2008-01-03 | ||
PCT/US2009/030030 WO2009089101A2 (en) | 2008-01-03 | 2009-01-02 | Medical systems, devices and methods for endoscopically suturing perforations |
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WO2016060406A1 (ko) * | 2014-10-15 | 2016-04-21 | 인제대학교 산학협력단 | 절개 기능을 가지는 자동 봉합 훅 기구 |
JP2017527378A (ja) * | 2014-09-10 | 2017-09-21 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | 長手方向ニードルパサー |
JP2018030008A (ja) * | 2011-05-08 | 2018-03-01 | アポロ エンドサージェリー,インコーポレイティド | 内視鏡縫合システム |
JP2018094325A (ja) * | 2016-12-16 | 2018-06-21 | 日本ゼオン株式会社 | 縫合装置 |
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Also Published As
Publication number | Publication date |
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CA2711300A1 (en) | 2009-07-16 |
AU2009204417B2 (en) | 2013-05-09 |
AU2009204417A1 (en) | 2009-07-16 |
US20090177031A1 (en) | 2009-07-09 |
EP2230987A2 (en) | 2010-09-29 |
JP5421927B2 (ja) | 2014-02-19 |
WO2009089101A2 (en) | 2009-07-16 |
EP2230987B1 (en) | 2013-02-27 |
US8876701B2 (en) | 2014-11-04 |
WO2009089101A3 (en) | 2009-10-22 |
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