JP2013540002A - 外科用装置を関節運動させるための制御特徴 - Google Patents
外科用装置を関節運動させるための制御特徴 Download PDFInfo
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Abstract
Description
本願は、開示が参照により本明細書に組み込まれる、2010年9月24日に出願された「Articulating Surgical Device」と題された米国仮出願第61/386,094号の優先権を主張する。
図1〜図4は、米国特許第6,500,176号、同第7,112,201号、同第7,125,409号、同許第7,169,146号、同第7,186,253号、同第7,189,233号、同第7,220,951号、同第7,309,849号、同第7,311,709号、同第7,354,440号、同第7,381,209号、米国特許公開第2011/0087218号、及び/又は米国特許出願第13/151,181号の教示のうちの少なくとも幾つかに従って構築され、動作可能である、例示的な電気外科用器具(10)を示す。その中に記載され、以下により詳細に記載されるように、電気外科用器具(10)は、実質的に同時に、組織を切断し、組織(例えば、血管など)を封止又は溶接するように動作可能である。換言すれば、電気外科用器具(10)は、電気外科用器具(10)が、組織を接合するホッチキスの線を提供する代わりに、双極無線周波数エネルギーの適用を通して組織溶接を提供することを除き、エンドカッター型のホッチキスと同様に動作する。また、電気外科用器具(10)は、Cincinnati,OhioのEthicon Endo−Surgery,Inc.によるENSEAL(登録商標)組織封止装置との様々な構造的及び機能的類似性を有してもよいことも理解されたい。更に、電気外科用器具(10)は、参照により本明細書に組み込まれる、他の引用文献のいずれかにおいて教示される装置との様々な構造的及び機能的類似性を有してもよい。本明細書の引用文献の教示、Cincinnati,OhioのEthicon Endo−Surgery,Inc.によるENSEAL(登録商標)組織封止装置と、電気外科用器具(10)に関する以下の教示との間にある程度の重複が存在する範囲内で、本明細書の説明のいずれかを自認した従来技術であると見なす意図はない。事実、以下の幾つかの教示は、本明細書の引用文献の教示、及びCincinnati,OhioのEthicon Endo−Surgery,Inc.によるENSEAL(登録商標)組織封止装置の範囲を越える。
本実施例の電気外科用器具(10)は、ハンドピース(20)と、ハンドピース(20)から遠位に延在するシャフト(30)と、シャフト(30)の遠位端に配置されるエンドエフェクタ(40)と、を含む。本実施例のハンドピース(20)は、ピストルグリップ(22)と、枢動トリガ(24)と、起動ボタン(26)と、関節制御(28)と、を含む。トリガ(24)は、以下により詳細に記載されるように、エンドエフェクタ(40)を選択的に作動させるように、ピストルグリップ(22)に向かって、及びそれから離れるように枢動可能である。起動ボタン(26)は、以下に同様により詳細に記載されるように、エンドエフェクタ(40)と連通している無線周波数回路を選択的に起動させるように動作可能である。幾つかのバージョンでは、また、起動ボタン(26)は、ボタン(26)が同時に押されない限り、トリガ(24)を完全に作動させることができないというような、トリガ(24)に対する機械的ロックアウトとしての機能も果たす。どのように上記のようなロックアウトが提供され得るかの実施例は、本明細書の引用文献の1つ以上に開示されている。ピストルグリップ(22)、トリガ(24)、及びボタン(26)は、任意の好適な方法で修正、置換、補完などされてもよく、本明細書のそのような構成要素の説明は、例証に過ぎないことを理解されたい。本実施例の関節制御(28)は、シャフト(30)の関節セクション(36)を選択的に制御するように動作可能であり、これは、以下により詳細に記載される。また、関節制御(28)がとり得る形態の様々な実施例も以下により詳細に記載され、同時に、本明細書の教示を考慮することで、更なる実施例が当業者に明らかになるであろう。
本実施例のエンドエフェクタ(40)は、第1のつかみ具(42)と、第2のつかみ具(44)と、を備える。本実施例では、第2のつかみ具(44)は、シャフト(30)に対して実質的に固定され、一方、第1のつかみ具(42)は、第2のつかみ具(42)に向かって、及びそれから離れるようにシャフト(30)に対して枢動する。幾つかのバージョンでは、ロッド又はケーブルなどの作動装置は、作動装置ロッド/ケーブルなどのシャフト(30)を通る長手方向移動が、シャフト(30)及び第2のつかみ具(44)に対する第1のつかみ具(42)の枢動を提供するように、シース(32)を通って延在し、枢動連結具(43)で第1のつかみ具(42)と接合されてもよい。もちろん、つかみ具(42、44)は、上記の代わりに、任意の他の好適な種類の移動を有してもよく、任意の他の好適な方法で作動されてもよい。一例として、及び以下により詳細に記載されるように、幾つかのバージョンでは、作動装置ロッド/ケーブルなどが単に排除され得るように、つかみ具(42、44)は、発射ビーム(60)の長手方向並進によって作動され、したがって閉鎖されてもよい。
また、図2〜図4にも見られるように、本実施例の電気外科用器具(10)は、エンドエフェクタ(40)の長さの部分に沿って長手方向に移動可能である、発射ビーム(60)を含む。発射ビーム(60)は、シャフト(30)内に同軸上に位置付けられ、シャフト(30)の長さに沿って延在し、シャフト(30)内(本実施例では、関節セクション(36)を含む)で長手方向に並進するが、とはいえ、発射ビーム(60)及びシャフト(30)は、任意の他の好適な関係を有してもよいことを理解されたい。発射ビーム(60)は、鋭い遠位ブレード(64)と、上フランジ(62)と、下フランジ(66)と、を含む。図4に最も良く見られるように、遠位ブレード(64)は、つかみ具(42、44)のスロット(46、48)を通って延在し、上フランジ(62)は、つかみ具(44)の上の陥凹(59)内に位置し、下フランジ(66)は、つかみ具(42)の下の陥凹(58)内に位置する。遠位ブレード(64)及びフランジ(62、66)の構成は、発射ビーム(60)の遠位端で「I形ビーム」型の断面を提供する。本実施例では、フランジ(62、66)は、発射ビーム(60)の長さのごく一部のみに沿って長手方向に延在するが、フランジ(62、66)は、発射ビーム(60)の任意の好適な長さに沿って長手方向に延在してもよいことを理解されたい。加えて、フランジ(62、66)は、つかみ具(42、44)の外側に沿って位置付けられているが、フランジ(62、66)は、代替えとして、つかみ具(42、44)内に形成される対応するスロット内に配置されてもよい。例えば、それぞれのつかみ具(42、44)が、「T字」形状のスロットを画定し、遠位ブレード(64)の部分が、それぞれの「T字」形状のスロットの1つの垂直部分内に配置され、フランジ(62、66)が、「T字」形状のスロットの水平部分内に配置されてもよい。本明細書の教示を考慮することで、様々な他の好適な構成及び関係が、当業者に明らかになるであろう。
例示的な使用では、エンドエフェクタ(40)は、トロカールを介して患者に挿入される。エンドエフェクタ(40)及びシャフト(30)の部分がトロカールを通して挿入される際、関節セクション(36)は、実質的にまっすぐである。次いで、エンドエフェクタ(40)を患者内の解剖学的構造に対する所望の位置及び配向に位置付けるために、シャフト(30)の関節セクション(36)を枢動させる、又は曲げるように、関節制御(28)が操作されてもよい。次いで、トリガ(24)をピストルグリップ(22)に向かって握持することによって、解剖学的構造の組織の2つの層が、つかみ具(42、44)の間に捕捉される。組織の上記のような層は、患者内の解剖学的構造(例えば、血管、胃腸管の部分、生殖器系の部分など)を画定する同一の自然管腔の部分であってもよい。例えば、一方の組織層は、血管の上部を備えてもよく、一方、他方の組織層は、血管の同一の長さ領域に沿った、血管の下部を備えてもよい(例えば、電気外科用器具(10)を使用する前の血管を通る流体経路が、エンドエフェクタ(40)によって画定される長手軸線に対して垂直であるようになど)。換言すれば、つかみ具(42、44)の長さは、血管の長さに対して垂直に(又は少なくとも概して横断方向に)配向されてもよい。上述されるように、トリガ(24)をピストルグリップ(22)に向かって握持することによって、発射ビーム(60)が遠位に作動される際、フランジ(62、66)は、つかみ具(44)を枢動させるように、つかみ具(44)に向かってカム作用する。
シャフト(30)の関節セクション(36)は、様々な形態をとってもよい。一例として、関節セクション(36)は、開示が参照により本明細書に組み込まれる、本願と同日に出願された「Articulation Joint Features for Articulating Surgical Device」と題された米国特許出願第[代理人整理番号END6889USNP]号の1つ以上の教示に従って構成されてもよい。別の単なる例証的な実施例として、関節セクション(36)は、開示が参照により本明細書に組み込まれる、本願と同日に出願された「Articulation Joint Features for Articulating Surgical Device」と題された米国特許出願第[代理人整理番号END6889USNP1]号の1つ以上の教示に従って構成されてもよい。更に、関節セクションは、本明細書の引用文献のうちの他の少なくとも1つの教示に従って構成されてもよい。本明細書の教示を考慮することで、関節セクション(36)がとり得る様々な他の好適な形態が、当業者に明らかになるであろう。
上述されるように、幾つかのバージョンのハンドピース(20)は、シャフト(30)の関節セクション(36)を制御し、それによってシース(32)によって画定される長手軸線に対して様々な角度でエンドエフェクタ(40)を選択的に位置付けるように動作可能である、関節制御(28)を含む。ハンドピース(20)の関節制御(28)及び他の構成要素がとり得る形態の幾つかの実施例が、以下により詳細に記載され、同時に、本明細書の教示を考慮することで、更なる実施例が、当業者に明らかになるであろう。一例として、関節制御(28)の幾つかの単なる例証的な代替えの実施例が、開示が参照により本明細書に組み込まれる、本願と同日に出願された「Control Features for Articulating Surgical Device」と題された米国特許出願第[代理人整理番号END6888USNP1]号に開示されている。
図5は、ハンドピース(120)と、ハンドピース(120)から遠位に延在するシャフト(130)と、シャフト(130)の遠位端に配置されるエンドエフェクタ(140)と、を含む、例示的な電気外科用器具(100)を示す。本実施例のハンドピース(120)は、ピストルグリップ(122)と、枢動トリガ(124)と、起動ボタン(126)と、回転関節ノブ(128)と、を含む。上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、トリガ(124)は、エンドエフェクタ(140)を選択的に作動させるように、ピストルグリップ(122)に向かって、及びそれから離れるように枢動可能である。同様に上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、起動ボタン(126)は、エンドエフェクタ(140)と通信している無線周波数回路を選択的に起動させるように動作可能である。幾つかのバージョンでは、また、起動ボタン(126)は、ボタン(126)が同時に押されない限り、トリガ(124)を完全に作動させることができないというような、トリガ(124)に対する機械的ロックアウトとしての機能も果たす。どのようにそのようなロックアウトの実施例が提供され得るかは、本明細書の引用文献の1つ以上に開示されている。ピストルグリップ(122)、トリガ(124)、及びボタン(126)は、任意の好適な方法で修正、置換、補完などされてもよく、本明細書のそのような構成要素の説明は、例証に過ぎないことを理解されたい。本実施例の関節ノブ(128)は、以下により詳細に記載されるように、シャフト(130)の関節セクション(136)を選択的に制御するように動作可能である。
図18は、ハンドピース(220)と、ハンドピース(220)から遠位に延在するシャフト(230)と、シャフト(230)の遠位端に配置されるエンドエフェクタ(240)と、を含む、例示的な電気外科用器具(200)を示す。本実施例のハンドピース(220)は、ピストルグリップ(222)と、枢動トリガ(224)と、起動ボタン(226)と、回転関節ノブ(228)と、を含む。上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、トリガ(224)は、エンドエフェクタ(240)を選択的に作動させるように、ピストルグリップ(222)に向かって、及びそれから離れるように枢動可能である。同様に上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、起動ボタン(226)は、エンドエフェクタ(240)と通信している無線周波数回路を選択的に起動させるように動作可能である。幾つかのバージョンでは、また、起動ボタン(226)は、ボタン(226)が同時に押されない限り、トリガ(224)を完全に作動させることができないというような、トリガ(224)に対する機械的ロックアウトとしての機能も果たす。どのように上記のようなロックアウトが提供され得るかの実施例は、本明細書の引用文献の1つ以上に開示されている。ピストルグリップ(222)、トリガ(224)、及びボタン(226)は、任意の好適な方法で修正、置換、補完などされてもよく、本明細書のそのような構成要素の説明は、例証に過ぎないことを理解されたい。本実施例の関節ノブ(228)は、以下により詳細に記載されるように、シャフト(230)の関節セクション(236)を選択的に制御するように動作可能である。
図22は、ハンドピース(320)と、ハンドピース(320)から遠位に延在するシャフト(330)と、シャフト(330)の遠位端に配置されるエンドエフェクタ(340)と、を含む、例示的な電気外科用器具(300)を示す。本実施例のハンドピース(320)は、ピストルグリップ(322)と、枢動トリガ(324)と、起動ボタン(326)と、枢動関節ノブ(328)と、を含む。上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、トリガ(324)は、エンドエフェクタ(340)を選択的に作動させるように、ピストルグリップ(322)に向かって、及びそれから離れるように枢動可能である。同様に上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、起動ボタン(326)は、エンドエフェクタ(340)と連通している無線周波数回路を選択的に起動させるように動作可能である。幾つかのバージョンでは、また、起動ボタン(326)は、ボタン(326)が同時に押されない限り、トリガ(324)を完全に作動させることができないというような、トリガ(324)に対する機械的ロックアウトとしての機能も果たす。どのようにそのようなロックアウトの実施例が提供され得るかは、本明細書の引用文献の1つ以上に開示されている。ピストルグリップ(322)、トリガ(324)、及びボタン(326)は、任意の好適な方法で修正、置換、補完などされてもよく、本明細書のそのような構成要素の説明は、例証に過ぎないことを理解されたい。本実施例の関節ノブ(328)は、以下により詳細に記載されるように、シャフト(330)の関節セクション(336)を選択的に制御するように動作可能である。
図26は、ハンドピース(420)と、ハンドピース(420)から遠位に延在するシャフト(430)と、シャフト(430)の遠位端に配置されるエンドエフェクタ(440)と、を含む、例示的な電気外科用器具(400)を示す。本実施例のハンドピース(420)は、ピストルグリップ(422)と、枢動トリガ(424)と、起動ボタン(426)と、枢動関節フィン(428)と、を含む。上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、トリガ(424)は、エンドエフェクタ(440)を選択的に作動させるように、ピストルグリップ(422)に向かって、及びそれから離れるように枢動可能である。同様に上述されるように、及び本明細書の1つ以上の引用文献に記載されるように、起動ボタン(426)は、エンドエフェクタ(440)と連通している無線周波数回路を選択的に起動させるように動作可能である。幾つかのバージョンでは、また、起動ボタン(426)は、ボタン(426)が同時に押されない限り、トリガ(424)を完全に作動させることができないというような、トリガ(424)に対する機械的ロックアウトとしての機能も果たす。どのようにそのようなロックアウトの実施例が提供され得るかは、本明細書の引用文献の1つ以上に開示されている。ピストルグリップ(422)、トリガ(424)、及びボタン(426)は、任意の好適な方法で修正、置換、補完などされてもよく、本明細書のそのような構成要素の説明は、例証に過ぎないことを理解されたい。本実施例の関節フィン(428)は、以下により詳細に記載されるように、シャフト(430)の関節セクション(436)を選択的に制御するように動作可能である。
明細書に記載される電気外科用器具(10)のいずれのバージョンも、上述されるものに加えて、又はそれらの代わりに、様々な他の特徴を含んでもよいことを理解されたい。上記のような他の特徴の幾つかの例が、以下に記載され、その一方で、本明細書の教示を考慮することで、他の特徴が当業者に明らかになるであろう。
上述されるように、エンドエフェクタ(40、140、240、340、440)の1つ以上の構成要素は、電源との電通状態に置かれてもよい。そのような電源は、器具(10、100、200、300、400)の内部であってもよく、又は器具の外部であってもよい。図30〜図36は、電源とエンドエフェクタ(40、140、240、340、440)の1つ以上の構成要素との間に電気的連結を提供するために使用されてもよい、幾つかの例示的な構成要素を示す。図30〜図36の実施例は、器具(100)の文脈において示されているが、実施例は、本明細書に記載される器具(10、200、300、400)の任意の他のバージョンに容易に適用され得ることを理解されたい。同様に、実施例は、本明細書の教示を考慮することで当業者に明らかになるであろう他の種類の器具の中でもとりわけ、本明細書の引用文献に記載される様々な器具に容易に適用され得る。
上述されるように、トリガ(24、124、224、324、424)は、エンドエフェクタ(40、140、240、340、440)を作動させるために、ピストルグリップ(22、124、224、324、424)に向かって握持されてもよい。前述の実施例では、バネ(図示せず)が、トリガ(24、124、224、324、424)をピストルグリップ(22、124、224、324、424)から離れるように弾性的に付勢する。したがって、ユーザーが、エンドエフェクタ(40、140、240、340、440)を作動させるために、トリガ(24、124、224、324、424)をピストルグリップ(22、124、224、324、424)に向かって完全に握持した後、ユーザーは、トリガ(24、124、224、324、424)を単に解放してもよく、次いでバネが、トリガ(24、124、224、324、424)を、ピストルグリップ(22、124、224、324、424)から離れるように枢動される、「定」位置に戻してもよい。幾つかのバージョンでは、関節セクション(36、136、236、336、436)による摩擦は、特に関節セクション(36、136、236、336、436)が屈曲構成である際に、トリガ(24、124、224、324、424)が定位置に戻るのに対する相当の抵抗を提供してもよい。この抵抗は、トリガ(24、124、224、324、424)がその戻りストロークの終わり付近にある際に、最も顕著であってもよい。したがって、場合によっては、トリガ(24、124、224、324、424)に、それが戻りストロークの終わりに近づく際に、追加の機械的支援を提供することが望ましい場合がある。
本明細書の実施例は、主に、電気外科用器具の文脈において記載されるが、本明細書の教示は、様々な他の種類の医療器具に容易に適用され得ることを理解されたい。一例として、本明細書の教示は、組織捕捉器具、組織取り込み袋配置器具、外科用ホッチキス、超音波外科用器具などに容易に適用され得る。また、本明細書の教示は、本明細書の引用文献のいずれかの教示と多数の方法で容易に組み合わせられ得るため、本明細書の教示は、本明細書の引用文献のいずれかに記載される器具のいずれにも容易に適用され得ることも理解されたい。本明細書の教示が組み込まれ得る他の種類の器具が、当業者に明らかになるであろう。
(1) 電気外科用装置であって、
(a)本体と、
(b)エンドエフェクタであって
(i)第1のつかみ具と、
(ii)第2のつかみ具と、
を備え、前記第1のつかみ具が、前記第1のつかみ具と前記第2のつかみ具との間に組織を挟持するように、前記第2のつかみ具に向かって移動可能であり、
前記つかみ具のうちの少なくとも1つが、少なくとも1つの電極を備え、
前記少なくとも1つの電極が、前記第1のつかみ具と前記第2のつかみ具との間に挟持される組織に無線周波数エネルギーを供給するように動作可能である、エンドエフェクタと、
(c)前記第1のつかみ具と前記第2のつかみ具との間に挟持される組織を切断するように動作可能な切断部材と、
(d)前記本体と前記エンドエフェクタとの間に延在するシャフトであって、前記シャフトが、長手軸線を画定し、前記シャフトが、関節セクションを含み、前記関節セクションが、前記エンドエフェクタを前記シャフトの前記長手軸線に対して非平行な位置に選択的に位置付けるように動作可能であり、前記本体が、前記関節セクションを選択的に作動させるように動作可能な制御装置を含む、シャフトと、を備える、電気外科用装置。
(2) 前記制御装置が、ノブを備える、実施態様1に記載の電気外科用装置。
(3) 前記ノブが、前記シャフトの前記長手軸線に対して垂直な平面に沿って回転可能である、実施態様2に記載の電気外科用装置。
(4) 前記ノブが、前記シャフトの前記長手軸線に対して傾斜した平面に沿って、前記シャフトの前記長手軸線を中心に回転可能である、実施態様2に記載の電気外科用装置。
(5) 前記制御装置が、球状駆動部を更に備え、前記ノブが、前記球状駆動部の周囲に配置される、実施態様4に記載の電気外科用装置。
(7) 前記制御装置が、前記第1のネジ山領域と係合される第1の主ネジと、前記第2のネジ山領域と係合される第2の主ネジとを更に備え、前記主ネジが、前記第1及び第2のネジ山領域が前記共通方向に回転されるのに応えて、逆方向に並進するように構成される、実施態様6に記載の電気外科用装置。
(8) 前記第1の主ネジと連結される第1の関節部材と、前記第2の主ネジと連結される第2の関節部材とを更に備え、前記第1及び前記第2の関節部材が、前記主ネジの並進に応えて、前記シャフトを通って長手方向に並進し、それによって前記関節セクションを作動させる、実施態様7に記載の電気外科用装置。
(9) 前記第1の主ネジを前記第1の関節部材と調整して連結するように、前記第1の主ネジと前記第1の関節部材との間で選択的に位置付け可能な第1の回転部材を更に備える、実施態様8に記載の電気外科用装置。
(10) 前記シャフトを通って長手方向に延在する第1の関節バンドと、前記シャフトを通って長手方向に延在する第2の関節バンドとを更に備え、第1及び第2の関節バンドが、前記関節セクションを選択的に屈曲又は枢動させるように、前記関節セクションと更に連結され、前記制御装置が、前記関節バンドを逆方向に並進させるように動作可能である、実施態様1に記載の電気外科用装置。
(12) 前記制御装置が、一対の対向するラックを更に備え、前記枢動部材が、ポストと、前記ラックと係合されるピニオンとを含み、前記ピニオンが、前記枢動部材の枢動に応えて、前記ラックを逆方向に同時に並進させるように動作可能であり、前記ラックが、前記ラックの逆方向の長手方向運動に基づき、前記関節セクションを屈曲又は枢動させるように動作可能である、実施態様11に記載の電気外科用装置。
(13) 前記枢動部材が、枢動平面に沿って枢動可能であり、前記関節セクションが、前記枢動平面に対応する関節平面に沿って屈曲又は枢動するように構成され、前記シャフト及び前記制御装置が、前記枢動平面及び前記関節平面が前記シャフトの前記長手軸線を中心に回転可能であるように、前記本体に対して前記シャフトの前記長手軸線を中心に回転可能である、実施態様11に記載の電気外科用装置。
(14) 前記枢動部材が、ユーザーの親指で係合可能なフィンを備える、実施態様11に記載の電気外科用装置。
(15) 前記制御装置が、前記枢動部材の枢動運動を2つの並進部材の逆方向の並進運動に変換するように動作可能な一対の結合アームを更に備え、前記並進部材が、前記並進部材の逆方向の並進に応えて、前記関節セクションを屈曲又は枢動させるように動作可能である、実施態様11に記載の電気外科用装置。
(17) 前記導電性連結具が、少なくとも2つの軸に沿って前記細長い部材と接触するように構成される、実施態様16に記載の電気外科用装置。
(18) (a)前記切断部材を作動させるように動作可能なトリガであって、カムアームを含む、トリガと、
(b)前記カムアームと係合されるトリガ戻りレバーであって、前記トリガを定位置に付勢するように構成される、トリガ戻りレバーと、を更に備える、実施態様1に記載の電気外科用装置。
(19) 外科用器具であって、
(a)本体と、
(b)組織を係合するように動作可能である、エンドエフェクタと、
(c)前記本体と前記エンドエフェクタとの間に延在するシャフトであって、前記シャフトが、長手軸線を画定し、前記シャフトが、関節セクションを含み、前記関節セクションが、前記エンドエフェクタを前記シャフトの前記長手軸線に対して非平行な位置に選択的に位置付けるように動作可能である、シャフトと、
(d)前記関節セクションを選択的に作動させるように動作可能な制御装置であって、
(i)前記本体に対して回転可能である、回転部材と、
(ii)前記シャフトを通って延在する第1の細長い部材と、
(iii)前記シャフトを通って延在する第2の細長い部材と、
を備え、前記回転部材が、前記回転部材の回転に応えて、前記第1及び第2の細長い部材を逆方向に同時に並進させるように動作可能であり、
前記第1及び第2の細長い部材が、前記細長い部材の逆方向への長手方向移動に応えて、前記関節セクションを屈曲又は枢動させるように構成される、制御装置と、を備える、外科用器具。
(20) 外科用器具であって、
(a)本体と、
(b)組織を係合するように動作可能である、エンドエフェクタと、
(c)前記本体と前記エンドエフェクタとの間に延在するシャフトであって、前記シャフトが、長手軸線を画定し、前記シャフトが、関節セクションを含み、前記関節セクションが、前記エンドエフェクタを前記シャフトの前記長手軸線に対して非平行な位置に選択的に位置付けるように動作可能である、シャフトと、
(d)前記関節セクションを選択的に作動させるように動作可能な制御装置であって、
(i)前記本体に対して回転可能である、回転部材と、
(ii)第1の配向を有するネジ切り部を含む、第1のネジ山領域と、
(iii)第2の配向を有するネジ切り部を含む、第2のネジ山領域であって、前記回転部材が、前記第1及び第2のネジ山領域を共通方向に同時に回転させるように動作可能である、第2のネジ山領域と、
(iv)前記第1のネジ山領域と係合される第1の主ネジと、
(v)前記第2のネジ山領域と係合される第2の主ネジであって、前記主ネジが、前記第1及び第2のネジ山領域が前記共通方向に回転されるのに応えて、逆方向に並進するように構成される、第2の主ネジと、を備える制御装置と、を備える、外科用器具。
Claims (10)
- 電気外科用装置であって、
(a)本体と、
(b)エンドエフェクタであって
(i)第1のつかみ具と、
(ii)第2のつかみ具と、
を備え、前記第1のつかみ具が、前記第1のつかみ具と前記第2のつかみ具との間に組織を挟持するように、前記第2のつかみ具に向かって移動可能であり、
前記つかみ具のうちの少なくとも1つが、少なくとも1つの電極を備え、
前記少なくとも1つの電極が、前記第1のつかみ具と前記第2のつかみ具との間に挟持される組織に無線周波数エネルギーを供給するように動作可能である、エンドエフェクタと、
(c)前記第1のつかみ具と前記第2のつかみ具との間に挟持される組織を切断するように動作可能な切断部材と、
(d)前記本体と前記エンドエフェクタとの間に延在するシャフトであって、前記シャフトが、長手軸線を画定し、前記シャフトが、関節セクションを含み、前記関節セクションが、前記エンドエフェクタを前記シャフトの前記長手軸線に対して非平行な位置に選択的に位置付けるように動作可能であり、前記本体が、前記関節セクションを選択的に作動させるように動作可能な制御装置を含む、シャフトと、を備える、電気外科用装置。 - 前記制御装置が、ノブを備える、請求項1に記載の電気外科用装置。
- 前記ノブが、前記シャフトの前記長手軸線に対して垂直な平面に沿って回転可能である、請求項2に記載の電気外科用装置。
- 前記ノブが、前記シャフトの前記長手軸線に対して傾斜した平面に沿って、前記シャフトの前記長手軸線を中心に回転可能である、請求項2に記載の電気外科用装置。
- 前記制御装置が、球状駆動部を更に備え、前記ノブが、前記球状駆動部の周囲に配置される、請求項4に記載の電気外科用装置。
- 前記制御装置が、第1のネジ山領域と、第2のネジ山領域とを含み、前記第1のネジ山領域が、第1の配向を有するネジ切り部を含み、前記第2のネジ山領域が、第2の配向を有するネジ切り部を含み、前記第2の配向が、前記第1の配向とは逆であり、前記制御装置が、前記第1及び前記第2のネジ山領域を共通方向に同時に回転させるように動作可能である、請求項1に記載の電気外科用装置。
- 前記制御装置が、前記第1のネジ山領域と係合される第1の主ネジと、前記第2のネジ山領域と係合される第2の主ネジとを更に備え、前記主ネジが、前記第1及び第2のネジ山領域が前記共通方向に回転されるのに応えて、逆方向に並進するように構成される、請求項6に記載の電気外科用装置。
- 前記第1の主ネジと連結される第1の関節部材と、前記第2の主ネジと連結される第2の関節部材とを更に備え、前記第1及び前記第2の関節部材が、前記主ネジの並進に応えて、前記シャフトを通って長手方向に並進し、それによって前記関節セクションを作動させる、請求項7に記載の電気外科用装置。
- 前記第1の主ネジを前記第1の関節部材と調整して連結するように、前記第1の主ネジと前記第1の関節部材との間で選択的に位置付け可能な第1の回転部材を更に備える、請求項8に記載の電気外科用装置。
- 前記シャフトを通って長手方向に延在する第1の関節バンドと、前記シャフトを通って長手方向に延在する第2の関節バンドとを更に備え、第1及び第2の関節バンドが、前記関節セクションを選択的に屈曲又は枢動させるように、前記関節セクションと更に連結され、前記制御装置が、前記関節バンドを逆方向に並進させるように動作可能である、請求項1に記載の電気外科用装置。
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JP7214651B2 (ja) | 2017-04-27 | 2023-01-30 | エシコン エルエルシー | 外科用器具における関節運動制御のための回り止め機構 |
WO2019069457A1 (ja) * | 2017-10-06 | 2019-04-11 | オリンパス株式会社 | 医療機器 |
US11589883B2 (en) | 2017-10-06 | 2023-02-28 | Olympus Corporation | Medical instrument |
JPWO2019069457A1 (ja) * | 2017-10-06 | 2020-10-22 | オリンパス株式会社 | 医療機器 |
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