JP2012526615A - 外科用締結具、アプリケータ器具、及び外科用締結具を展開する方法 - Google Patents
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- A—HUMAN NECESSITIES
- 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
- 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
- A61B17/04—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
- A61B17/06166—Sutures
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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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
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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
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
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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
- A61B2017/2946—Locking means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, 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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
Abstract
Description
本出願は、本出願と同日出願の、以下の本発明の譲受人に譲渡された米国特許出願に関連する:2009年5月__出願の米国特許出願第__________号(ETH5435USNP)、2009年5月__出願の米国特許出願第__________号(ETH5436USNP)、2009年5月__出願の米国特許出願第__________号(ETH5437USNP)。上記で指定される特許出願の開示は本明細書において参照として組み込まれる。
本発明は一般的に、外科用締結具、より具体的にはアプリケータ器具、外科用締結具を展開するためのシステム及び方法に関連する。
ヘルニアは、患者の腹部筋肉壁又は股間内の弱い場所又は欠陥を貫通して腸管又は腸の小さいループが突出する状態である。この状態は一般的にヒト、特に男性に生じる。この種類のヘルニアは、先天性の欠陥から生じる場合があり、したがって患者は生まれつきこの問題を有するか又は酷使若しくは重いものを持ち上げることによって生じ得る。重いものを持ち上げることは、腹壁に多大な圧力を生じ、腹筋の弱い部分で破裂又は破断を生じ、欠損部又は開口を生じる場合があることが既知であり得る。いずれの場合においても、患者はその欠損部を貫通して突出する見た目の悪い腸組織の出っ張り、これが痛み、持ち上げる力の低下を生じる場合があり、場合によっては大腸の圧迫、又は、突出組織への血流が遮断された場合は他の合併症の可能性がある。
(1) 外科用締結具であって、
第1脚部であって、遠位端、近位端、及び前記第1脚部の前記遠位端の第1挿入先端部を含む、第1脚部と、
第2脚部であって、遠位端、近位端、及び前記第2脚部の前記遠位端の第2挿入先端部を含む、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続する、ブリッジと、
第1挿入ツール座部表面を有する、前記第1挿入先端部と、
第2挿入ツール座部表面を有する、前記第2挿入先端部と、を含む、外科用締結具。
(2) 前記第1脚部及び前記第2脚部が、各長手方向軸に沿って延び、前記第1挿入先端部及び前記第2挿入先端部が、前記各長手方向軸に対して外側に傾斜する、実施態様1に記載の外科用締結具。
(3) 前記第1挿入先端部及び前記第2挿入先端部の少なくとも一方が、鈍い遠位貫通点を含む、実施態様1に記載の外科用締結具。
(4) 前記第1挿入先端部が、前記第1挿入ツール座部表面を含む近位端を含み、前記第2挿入先端部が、前記第2挿入ツール座部表面を含む近位端を含む、実施態様1に記載の外科用締結具。
(5) 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端よりも前記第1脚部の前記遠位端に近く、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端よりも前記第2脚部の前記遠位端に近い、実施態様1に記載の外科用締結具。
(6) 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端の方を向き、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端の方を向く、実施態様1に記載の外科用締結具。
(7) 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端の方を向く開口部を含み、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端の方を向く第2開口部を含む、実施態様1に記載の外科用締結具。
(8) 前記第1挿入ツール座部表面が、前記第1挿入先端部を通じて延びる第1穴を含み、前記第2挿入ツール座部表面が、前記第2挿入先端部を通じて延びる第2穴を含む、実施態様1に記載の外科用締結具。
(9) 前記第1脚部が、前記第1脚部の前記近位端と前記第1挿入ツール座部表面との間に延びる第1位置合わせ案内部を含み、前記第2脚部が、前記第2脚部の前記近位端と前記第2挿入ツール座部表面との間に延びる第2位置合わせ案内部を含む、実施態様1に記載の外科用締結具。
(10) 前記第1脚部上の前記第1位置合わせ案内部が、前記第1挿入ツール座部表面と実質的に位置合わせされ、前記第2脚部上の前記第2位置合わせ案内部が、前記第2挿入ツール座部表面と実質的に位置合わせされる、実施態様9に記載の外科用締結具。
(12) 前記第1挿入先端部及び前記第2挿入先端部が、互いにずらして配置された遠位端を有する、実施態様1に記載の外科用締結具。
(13) 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いにずらして配置される、実施態様1に記載の外科用締結具。
(14) 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに外側に向かって突出する、実施態様1に記載の外科用締結具。
(15) 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに内側に向かって突出する、実施態様1に記載の外科用締結具。
(16) 前記第1脚部及び前記第2脚部の前記近位端を接続する前記ブリッジが、第3挿入ツール座部表面を画定する、実施態様1に記載の外科用締結具。
(17) 前記外科用締結具が吸収性である、実施態様1に記載の外科用締結具。
(18) 医療装置を組織に固定するための外科用締結具であって、
第1脚部であって、遠位端、近位端、前記第1脚部の前記遠位端と前記近位端との間に延びる第1位置合わせ案内部、及び前記第1脚部の前記遠位端の第1挿入先端部を有する、第1脚部と、
第2脚部であって、遠位端、近位端、前記第2脚部の前記遠位端と前記近位端との間に延びる第2位置合わせ案内部、及び前記第2脚部の前記遠位端の第2挿入先端部を有する、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続するブリッジと、を含む、外科用締結具。
(19) 前記第1挿入先端部が、第1挿入ツール座部表面を含む近位端を含み、前記第2挿入先端部が、第2挿入ツール座部表面を含む近位端を含む、実施態様18に記載の外科用締結具。
(20) 前記第1挿入ツール座部表面及び前記第2挿入ツール座部表面が、前記第1脚部及び前記第2脚部の前記近位端の方を向く凸状表面、前記第1脚部及び前記第2脚部の前記近位端の方を向く凹状表面、前記第1脚部及び前記第2脚部の前記近位端の方を向く開口部、前記第1脚部及び前記第2脚部の前記近位端の方を向く盲導通孔、並びに前記第1挿入先端部及び前記第2挿入先端部を通じて延びる穴からなる群から選択される、実施態様19に記載の外科用締結具。
(22) 前記第1挿入先端部及び前記第2挿入先端部が互いにずらして配置される、実施態様18に記載の外科用締結具。
(23) 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに外側に向かって突出する、実施態様18に記載の外科用締結具。
(24) 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに内側に向かって突出する、実施態様18に記載の外科用締結具。
(25) 医療装置を組織に固定するための外科用締結具であって、
第1脚部であって、遠位端、近位端、前記第1脚部の前記遠位端と前記近位端との間に延びる第1位置合わせ案内部、及び前記第1脚部の前記遠位端の第1挿入先端部を有し、前記第1挿入先端部は第1挿入ツール座部表面を有する、第1脚部と、
第2脚部であって、遠位端、近位端、前記第2脚部の前記遠位端と前記近位端との間に延びる第2位置合わせ案内部、及び前記第2脚部の前記遠位端の第2挿入先端部を有し、前記第2挿入先端部は第2挿入ツール座部表面を有する、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続する、ブリッジと、を含む、外科用締結具。
(26) 前記第1位置合わせ案内部及び前記第2位置合わせ案内部が、前記脚部の前記遠位端と前記近位端との間に延びるリブ、及び前記脚部の前記遠位端と前記近位端との間に延びる溝からなる位置合わせ案内部の群から選択される、実施態様25に記載の外科用締結具。
(27) 前記第1位置合わせ案内部が、前記第1挿入ツール座部表面と実質的に位置合わせされ、前記第2位置合わせ案内部が、前記第2挿入ツール座部表面と実質的に位置合わせされる、実施態様25に記載の外科用締結具。
(28) 前記第1座部表面及び前記第2座部表面が、前記外科用締結具の近位端よりも前記外科用締結具の遠位端に近い、実施態様25に記載の外科用締結具。
(29) 前記第1挿入先端部及び前記第2挿入先端部が、互いに第1距離で離間した遠位点を有し、前記第1脚部及び第2脚部が、互いに第2距離で離間しており、前記第1距離は前記第2距離よりも大きい、実施態様25に記載の外科用締結具。
Claims (29)
- 外科用締結具であって、
第1脚部であって、遠位端、近位端、及び前記第1脚部の前記遠位端の第1挿入先端部を含む、第1脚部と、
第2脚部であって、遠位端、近位端、及び前記第2脚部の前記遠位端の第2挿入先端部を含む、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続する、ブリッジと、
第1挿入ツール座部表面を有する、前記第1挿入先端部と、
第2挿入ツール座部表面を有する、前記第2挿入先端部と、を含む、外科用締結具。 - 前記第1脚部及び前記第2脚部が、各長手方向軸に沿って延び、前記第1挿入先端部及び前記第2挿入先端部が、前記各長手方向軸に対して外側に傾斜する、請求項1に記載の外科用締結具。
- 前記第1挿入先端部及び前記第2挿入先端部の少なくとも一方が、鈍い遠位貫通点を含む、請求項1に記載の外科用締結具。
- 前記第1挿入先端部が、前記第1挿入ツール座部表面を含む近位端を含み、前記第2挿入先端部が、前記第2挿入ツール座部表面を含む近位端を含む、請求項1に記載の外科用締結具。
- 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端よりも前記第1脚部の前記遠位端に近く、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端よりも前記第2脚部の前記遠位端に近い、請求項1に記載の外科用締結具。
- 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端の方を向き、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端の方を向く、請求項1に記載の外科用締結具。
- 前記第1挿入ツール座部表面が、前記第1脚部の前記近位端の方を向く開口部を含み、前記第2挿入ツール座部表面が、前記第2脚部の前記近位端の方を向く第2開口部を含む、請求項1に記載の外科用締結具。
- 前記第1挿入ツール座部表面が、前記第1挿入先端部を通じて延びる第1穴を含み、前記第2挿入ツール座部表面が、前記第2挿入先端部を通じて延びる第2穴を含む、請求項1に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端と前記第1挿入ツール座部表面との間に延びる第1位置合わせ案内部を含み、前記第2脚部が、前記第2脚部の前記近位端と前記第2挿入ツール座部表面との間に延びる第2位置合わせ案内部を含む、請求項1に記載の外科用締結具。
- 前記第1脚部上の前記第1位置合わせ案内部が、前記第1挿入ツール座部表面と実質的に位置合わせされ、前記第2脚部上の前記第2位置合わせ案内部が、前記第2挿入ツール座部表面と実質的に位置合わせされる、請求項9に記載の外科用締結具。
- 前記第1位置合わせ案内部及び前記第2位置合わせ案内部が、前記脚部の前記遠位端と前記近位端との間に延びるリブ、及び前記脚部の前記遠位端と前記近位端との間に延びる溝からなる位置合わせ案内部の群から選択される、請求項9に記載の外科用締結具。
- 前記第1挿入先端部及び前記第2挿入先端部が、互いにずらして配置された遠位端を有する、請求項1に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いにずらして配置される、請求項1に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに外側に向かって突出する、請求項1に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに内側に向かって突出する、請求項1に記載の外科用締結具。
- 前記第1脚部及び前記第2脚部の前記近位端を接続する前記ブリッジが、第3挿入ツール座部表面を画定する、請求項1に記載の外科用締結具。
- 前記外科用締結具が吸収性である、請求項1に記載の外科用締結具。
- 医療装置を組織に固定するための外科用締結具であって、
第1脚部であって、遠位端、近位端、前記第1脚部の前記遠位端と前記近位端との間に延びる第1位置合わせ案内部、及び前記第1脚部の前記遠位端の第1挿入先端部を有する、第1脚部と、
第2脚部であって、遠位端、近位端、前記第2脚部の前記遠位端と前記近位端との間に延びる第2位置合わせ案内部、及び前記第2脚部の前記遠位端の第2挿入先端部を有する、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続するブリッジと、を含む、外科用締結具。 - 前記第1挿入先端部が、第1挿入ツール座部表面を含む近位端を含み、前記第2挿入先端部が、第2挿入ツール座部表面を含む近位端を含む、請求項18に記載の外科用締結具。
- 前記第1挿入ツール座部表面及び前記第2挿入ツール座部表面が、前記第1脚部及び前記第2脚部の前記近位端の方を向く凸状表面、前記第1脚部及び前記第2脚部の前記近位端の方を向く凹状表面、前記第1脚部及び前記第2脚部の前記近位端の方を向く開口部、前記第1脚部及び前記第2脚部の前記近位端の方を向く盲導通孔、並びに前記第1挿入先端部及び前記第2挿入先端部を通じて延びる穴からなる群から選択される、請求項19に記載の外科用締結具。
- 前記第1位置合わせ案内部及び前記第2位置合わせ案内部が、前記脚部の前記遠位端と前記近位端との間に延びるリブ、及び前記脚部の前記遠位端と前記近位端との間に延びる溝からなる位置合わせ案内部の群から選択される、請求項18に記載の外科用締結具。
- 前記第1挿入先端部及び前記第2挿入先端部が互いにずらして配置される、請求項18に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに外側に向かって突出する、請求項18に記載の外科用締結具。
- 前記第1脚部が、前記第1脚部の前記近位端の方に突出する第1返し部を含み、前記第2脚部が、前記第2脚部の前記近位端の方に突出する第2返し部を含み、前記第1返し部及び前記第2返し部が、互いに内側に向かって突出する、請求項18に記載の外科用締結具。
- 医療装置を組織に固定するための外科用締結具であって、
第1脚部であって、遠位端、近位端、前記第1脚部の前記遠位端と前記近位端との間に延びる第1位置合わせ案内部、及び前記第1脚部の前記遠位端の第1挿入先端部を有し、前記第1挿入先端部は第1挿入ツール座部表面を有する、第1脚部と、
第2脚部であって、遠位端、近位端、前記第2脚部の前記遠位端と前記近位端との間に延びる第2位置合わせ案内部、及び前記第2脚部の前記遠位端の第2挿入先端部を有し、前記第2挿入先端部は第2挿入ツール座部表面を有する、第2脚部と、
前記外科用締結具の閉鎖端部を形成するために、前記第1脚部及び前記第2脚部の前記近位端を接続する、ブリッジと、を含む、外科用締結具。 - 前記第1位置合わせ案内部及び前記第2位置合わせ案内部が、前記脚部の前記遠位端と前記近位端との間に延びるリブ、及び前記脚部の前記遠位端と前記近位端との間に延びる溝からなる位置合わせ案内部の群から選択される、請求項25に記載の外科用締結具。
- 前記第1位置合わせ案内部が、前記第1挿入ツール座部表面と実質的に位置合わせされ、前記第2位置合わせ案内部が、前記第2挿入ツール座部表面と実質的に位置合わせされる、請求項25に記載の外科用締結具。
- 前記第1座部表面及び前記第2座部表面が、前記外科用締結具の近位端よりも前記外科用締結具の遠位端に近い、請求項25に記載の外科用締結具。
- 前記第1挿入先端部及び前記第2挿入先端部が、互いに第1距離で離間した遠位点を有し、前記第1脚部及び第2脚部が、互いに第2距離で離間しており、前記第1距離は前記第2距離よりも大きい、請求項25に記載の外科用締結具。
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EP2964107B1 (en) | 2013-03-09 | 2019-04-17 | Ethicon LLC | Surgical fasteners having articulating joints and deflectable tips |
USD706135S1 (en) | 2013-03-13 | 2014-06-03 | Frederick A. Hutchison | Container cap |
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USD744857S1 (en) | 2013-03-15 | 2015-12-08 | Mccormick & Company, Incorporated | Bottle with cap |
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2009
- 2009-05-12 US US12/464,143 patent/US8894669B2/en active Active
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2010
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US10729433B2 (en) | 2009-05-12 | 2020-08-04 | Ethicon, Inc. | Applicator instruments for dispensing surgical fasteners having distal end caps with castling for engaging opposing surfaces |
US11413039B2 (en) | 2009-05-12 | 2022-08-16 | Ethicon, Inc. | Applicator instruments for dispensing surgical fasteners having firing systems with slower piloting stages and faster dispensing stages |
JP2011041805A (ja) * | 2009-08-19 | 2011-03-03 | Tyco Healthcare Group Lp | 外科手術ステープル |
KR20150126928A (ko) * | 2013-03-09 | 2015-11-13 | 에디컨인코포레이티드 | 관절형 조인트 및 편향가능한 팁을 갖는 수술용 패스너 |
JP2016508826A (ja) * | 2013-03-09 | 2016-03-24 | エシコン・インコーポレイテッドEthicon, Inc. | 関節接合部及び偏向式先端部分を有する外科用締結具 |
KR102213505B1 (ko) * | 2013-03-09 | 2021-02-08 | 에티컨, 엘엘씨 | 관절형 조인트 및 편향가능한 팁을 갖는 수술용 패스너 |
KR20150127260A (ko) * | 2013-03-14 | 2015-11-16 | 에디컨인코포레이티드 | 수술용 패스너를 위한 어플리케이터 시스템 |
JP2016511062A (ja) * | 2013-03-14 | 2016-04-14 | エシコン・インコーポレイテッドEthicon, Inc. | 外科用締結具のアプリケータシステム |
KR102206135B1 (ko) * | 2013-03-14 | 2021-01-25 | 에디컨인코포레이티드 | 수술용 패스너를 위한 어플리케이터 시스템 |
JP2016537042A (ja) * | 2013-09-26 | 2016-12-01 | サージマティクス, インコーポレーテッドSurgimatix, Inc. | 自動装填機構及び縫合要素捕捉部を備えた腹腔鏡縫合装置 |
US10398432B2 (en) | 2013-09-26 | 2019-09-03 | Surgimatix, Inc. | Laparoscopic suture device with autoloading and suture capture |
US9936942B2 (en) | 2013-09-26 | 2018-04-10 | Surgimatix, Inc. | Laparoscopic suture device with release mechanism |
US9603592B2 (en) | 2013-09-26 | 2017-03-28 | Surgimatix, Inc. | Laparoscopic suture device with autoloading and suture capture |
WO2015048465A1 (en) * | 2013-09-26 | 2015-04-02 | Surgimatix, Inc. | Laparoscopic suture device with autoloading and suture capture |
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