JP2013545532A - モジュール式シャフト及びエンドエフェクタを備える外科用器具 - Google Patents
モジュール式シャフト及びエンドエフェクタを備える外科用器具 Download PDFInfo
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- JP2013545532A JP2013545532A JP2013537830A JP2013537830A JP2013545532A JP 2013545532 A JP2013545532 A JP 2013545532A JP 2013537830 A JP2013537830 A JP 2013537830A JP 2013537830 A JP2013537830 A JP 2013537830A JP 2013545532 A JP2013545532 A JP 2013545532A
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- assembly
- end effector
- surgical instrument
- coupling
- shaft
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Abstract
Description
本出願は、その開示が参照により本明細書に組み込まれる、2010年11月5日出願の「Energy−Based Surgical Instruments」と題する米国特許仮出願第61/410,603号に対する優先権を主張する。
図1は、超音波外科用器具(50)、ゼネレータ(20)、及びゼネレータ(20)を外科用器具(50)に連結するように操作可能なケーブル(30)を含む例示的な超音波外科用システム(10)を示す。好適なゼネレータ(20)は、GEN 300(Cincinnati,OhioのEthicon Endo−Surgery,Inc.により販売)である。単なる例として、ゼネレータ(20)は、その開示が参照により本明細書に組み込まれる、2011年4月14日公開の「Surgical Generator for Ultrasonic and Electrosurgical Devices」と題する米国特許出願公開第2011/0087212号の教示に従って構成することができる。外科用器具(50)は超音波外科用器具を参照して記載されるが、以下に記載する技術は、本明細書の教示を考慮することで当業者には明かとなるであろうように、エンドカッター、把持具、カッター、ステープラー、クリップ適用器具、アクセス装置、薬物/遺伝子治療送達装置、及び超音波、RF、レーザー等を使用するエネルギー送達装置、並びに/又はこれらの任意の組み合わせを含むが、これらに限定されない多様な外科用器具と共に使用できることに留意するべきである。また、本実施例をケーブル接続の外科用器具(50)を参照して説明するが、外科用器具(50)は、その開示が参照により本明細書に組み込まれる、2009年6月4日公開の「Cordless Hand−held Ultrasonic Cautery Cutting Device」と題する米国特許出願公開第2009/0143797号に開示されているもの等のコードレストランス操作に適合されてもよいということが理解されるべきである。更に、外科用装置(50)は、また、2004年8月31日発行の「Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument」と題する米国特許第6,783,524号に開示されたようなロボット支援手術環境で使用されるか、又は使用に適合されてもよい。
一部の外科用器具は、組織の手術のために超音波エネルギーを使用するようになされている一方で、図2〜3Bに示す外科用器具(150)などの他の外科用器具は、電気エネルギー及び/又は熱エネルギーなどのエネルギーを患者の組織に供給するように構成可能である。外科用器具(150)は、ハンドルアセンブリ(152)、伝達用アセンブリ(170)、及び伝達用アセンブリ(170)の遠位端に連結されたエンドエフェクタ(200)(図3A〜3Bに図示)を含む。下記により詳細に述べるように、ハンドルアセンブリ(152)は、エンドエフェクタ(200)に電気エネルギーを供給し、及び/又はエンドエフェクタ(200)内でナイフ又は切断部材(210)(図3A〜3Bに図示)を進めて、エンドエフェクタ(200)内で位置決めした組織を切り離すために1つ又は2つ以上のスイッチ及び/又はトリガーを含んでもよい。
図2を参照すると、ハンドルアセンブリ(152)は、ゼネレータ(20)などの電源(図示せず)及び/又は例えば、ハンドルアセンブリ(152)内に収容されている電源を含む、任意の他の電源と操作可能なように連結されている1つ又は2つ以上の電気的入力(160)を含む。伝達用アセンブリ(170)は、ハンドルアセンブリ(152)から遠位に延び、伝達用アセンブリ(170)の遠位端に連結したエンドエフェクタ(200)を含む。電源は、外科用器具(150)に電流を提供し、及び電源は、外科用器具(150)に所望の量のエネルギーを提供するために電流の大きさ、継続時間、波形、及び/又は周波数を制御するように操作可能であってもよい。本実施例のハンドルアセンブリ(152)は、インプット(160)に供給される電流がエンドエフェクタ(200)まで伝達可能なように、伝達用アセンブリ(170)から延びる第1の導体(220)により電気的入力(160)を電気的に連結するために、スイッチ又はトリガー(156)に対応するように構成されているハンドル本体(154)を含む。図2に示すように、ハンドル本体(154)は、一緒に組み立てられてハンドル本体(154)を形成する、2つの長手方向に二つ割りにした部分を含む。図2に示すように、一方の部分を省略して、ハンドルアセンブリ(152)の様々な内部の構成要素の一部を示す。様々な実施形態では、本明細書の教示を考慮すれば当業者には明らかであるように、ハンドル本体(154)の半体を、スナップ嵌め、プレス嵌め、溶接、接着、及び/又は相互締め付けを施すことができる。更になお、ハンドルアセンブリ(152)は、2つの別々の半体の代わりに一体化した片であってもよい。更に別の代替法では、この部分は半体でないが、単に取り外し可能な頂部及び/又は側面部分付きのハンドル本体(154)などの別々の連結可能な構成要素であってもよい。ハンドル本体(154)に対する更なる他の構成は、本明細書の教示を考慮することで当業者には明かとなるであろう。
本実施例のエンドエフェクタ(200)は、上つかみ部(206)及び下つかみ部(208)を含む。上つかみ部(206)は、下つかみ部(208)に対して旋回可能であり、シャフト(174)の作動により組織を上つかみ部(206)と下つかみ部(208)との間で挟むように操作可能である。シャフト(174)の作動は、トリガー(156)を第2のトリガー、ボタン、モーター、ソレノイド、及び/又は任意の他の好適な方法により作動することにより行われてもよい。本実施例の上つかみ部(206)及び下つかみ部(208)の両方は、エンドエフェクタ(200)の近位端(202)と遠位端(204)との間に延びる第1の電極(230)を含む(図3A〜3Bに図示)。図4に示すように、本実施例の第1の電極(230)は、上つかみ部(206)及び下つかみ部(208)の両方の第1の側面に沿って延びる第1の側面部分、上つかみ部(206)及び下つかみ部(208)の両方の第2の側面に沿って延びる第2の側面部分、並びに上つかみ部(206)及び下つかみ部(208)の両方に対して第1の側面部分及び第2の側面部分を接続する横方向端部含む。本実施例の上つかみ部(206)及び下つかみ部(208)は、第1の電極(230)から絶縁され、かつ第1の電極(230)から挿入された類似の形状の第2の電極(232)を第1の電極(230)として更に含む。一部の変形では、第1の電極(230)は、代わりに上つかみ部(206)に対しては第2の電極(232)の挿入物であってよく、第2の電極(232)は、下つかみ部(208)に対しては第1の電極(230)の挿入物であってよく、その逆も成り立つ。他の変形では、上つかみ部(206)は第1の電極(230)のみを含み、下つかみ部(208)は第2の電極(232)のみを含み、その逆も成り立つ。更に別の構成では、第2の電極(232)は切断部材(210)により作動可能であってもよい。上つかみ部(206)及び下つかみ部(208)は両方とも、切断部材(210)の長手方向の並進が可能となるように構成された長手方向のチャンネル(図示せず)を含む。エンドエフェクタ(200)に対する更に他の構成は、その開示が参照により本明細書に組み込まれる、米国特許第6,500,176号、同第7,112,201号、同第7,125,409号、同第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、米国特許出願公開第2011/0087218号、及び/又は2011年6月2日出願の「Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback」と題する米国特許出願第13/151,181号に開示されている。
一部の事例では、同一のハンドルアセンブリ(60、152)を用いながら、様々なシャフトの長さ及び/又は様々な形のエンドエフェクタ(80、200)の間で変えることは有用であることがある。例えば、一部の処置において、大量の組織を切断する必要があり、様々な長さのエンドエフェクタ(80、200)、及び/又は伝達用アセンブリ(70、170)のためのシャフトを必要とすることがある。このような交換可能なシャフト及び/又はエンドエフェクタ(80、200)は、様々な外科的処置(例えば、開腹手術のための短いシャフト、低侵襲的腹腔鏡手術のための長いシャフト等)のために共通のハンドルアセンブリ(60、152)が用いられるのを可能にすることもある。更に、同一のハンドルアセンブリ(60、152)を再使用しながら、シャフト及び/又はエンドエフェクタ(80、200)を交換することは、様々な長さのシャフトの新たな外科用器具(50、150)を使用することに比べて、時間効率及び/又は費用効率がより高いこともある。単なる一例であるが、このようなシャフト及び/又はエンドエフェクタ(80、200)は、様々な長さ及び/又は種類を識別するためのカラーコードを備えることができる。別の事例では、ハンドルアセンブリ(60、152)は、様々な形のエンドエフェクタを用いるように構成され得、例えば、ハンドルアセンブリ(60、152)は、超音波エンドエフェクタ(80)及び/又はRFエンドエフェクタ(200)を操作するための構成要素を具備してもよい。このように、シャフト及び/又はエンドエフェクタ(80、200)を共通のハンドルアセンブリ(60、152)により交換することによって、時間及び/又はコストを節約することができる。したがって、モジュール式シャフトをハンドルアセンブリ(60、152)に連結するための様々な連結機構を以下に記述する。超音波エンドエフェクタ(80)が用いられる方法において、トランスデューサ(100)の少なくとも一部は、シャフト及びエンドエフェクタ(80)と一体になっていてもよく、したがって、ハンドルアセンブリ(60)と選択的に連結されていてもよいということが理解されるべきである。代わりに、トランスデューサ(100)は、シャフト及びエンドエフェクタ(80)がハンドルアセンブリ(60)と選択的に連結されるとき、シャフト及びエンドエフェクタ(80)がトランスデューサ(100)と選択的に連結されるように、ハンドルアセンブリ(60)と一体化していてもよい。
第1の例示的な連結機構(300)は、例示的なエンドエフェクタアセンブリ(310)のシャフト(320)の挿入可能な部分から延びるタブ(302)を含む(図5A〜5Bに図示)。本実施例において、エンドエフェクタアセンブリ(310)は、伝達用アセンブリ(312)と、回転ノブ(314)と、回転ノブ(314)に対して近位に延びるシャフト(320)とを含む。回転ノブ(314)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。他の変形では、回転ノブ(314)はハンドルアセンブリ(340)に連結されてもよく、エンドエフェクタアセンブリ(310)は回転ノブ(314)を通じて挿入されてもよい。回転ノブ(314)は、ハンドルアセンブリ(340)及び/又はシャフト(320)に対して伝達用アセンブリ(312)を回転させることができる。エンドエフェクタ(図示せず)は、伝達用アセンブリ(312)の遠位端に連結される。エンドエフェクタは、本明細書の教示を考慮すれば当業者には明らかであるように、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)、及び/又は任意の他のエンドエフェクタ又はエンドエフェクタの組み合わせを含んでもよい。エンドエフェクタ(80)などの超音波エンドエフェクタの事例では、シャフト(320)を通るシャフト穴(図示せず)は、伝達用アセンブリ(312)のシャフト(320)からのハンドルアセンブリ(340)内部の構成要素への機械的な連結を可能とし、上述の組立形ハンドルアセンブリ(60)に類似する方法で構成されてもよい。エンドエフェクタ(200)などのRFエンドエフェクタの場合、シャフト穴は、伝達用アセンブリ(312)の一部が、少なくとも部分的にシャフト(320)を通って延びるのを可能にする。伝達用アセンブリ(312)は、ハンドルアセンブリ(340)からエンドエフェクタへ電気的連結を行うことができるように、シャフト(320)内部の補足的なスリップリングコネクタに電気的に連結可能な内部スリップリングコネクタを具備してもよい。更にもう1つの代替例では、シャフト(320)を通り抜ける穴、及び/又は、エンドエフェクタアセンブリ(310)上の他の場所経由で流体連結を行うこともできる。
第2の例示的な連結機構(400)は、代替的な例示的なエンドエフェクタアセンブリ(410)のシャフト(420)を捕捉するように構成された、ケーシング(444)の弾性付勢された部分(450)を含む(図6A〜6Bに図示)。本実施例において、エンドエフェクタアセンブリ(410)は、伝達用アセンブリ(412)と、回転ノブ(414)と、回転ノブ(414)に対して近位に延びるシャフト(420)とを含む。回転ノブ(414)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(414)は、ハンドルアセンブリ(440)及び/又はシャフト(420)に対して伝達用アセンブリ(412)を回転させることができる。エンドエフェクタ(図示せず)は、伝達用アセンブリ(412)の遠位端に連結される。エンドエフェクタは、本明細書の教示を考慮すれば当業者には明らかであるように、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)、及び/又は任意の他のエンドエフェクタ又はエンドエフェクタの組み合わせを含んでもよい。エンドエフェクタ(80)等の超音波エンドエフェクタの事例では、シャフト(420)を通るシャフト穴(図示せず)は、シャフト(420)を通る伝達用アセンブリ(412)が、上述の組立形ハンドルアセンブリ(60)に類似する方法で構成されることが可能な、ハンドルアセンブリ(440)内部の構成要素へ機械的に連結されるのを可能にする。エンドエフェクタ(200)などのRFエンドエフェクタの場合、シャフト穴は、伝達用アセンブリ(412)の一部が、少なくとも部分的にシャフト(420)を通って延びるのを可能にする。伝達用アセンブリ(412)は、ハンドルアセンブリ(440)からエンドエフェクタへ電気的連結を行うことができるように、シャフト(420)内部の補足的スリップリングコネクタに電気的に連結することのできる内部スリップリングコネクタを具備してもよい。更にもう1つの代替例では、シャフト(420)を通り抜ける穴、及び/又はエンドエフェクタアセンブリ(410)上の他の場所経由で流体連結を行うこともできる。
第3の例示的な連結機構(500)は、更に別の例示的なエンドエフェクタアセンブリ(510)のシャフト(520)を捕捉するように構成されたケーシング(544)のスライドロック部分(550)を含む(図7A〜7Bに図示)。本実施例において、エンドエフェクタアセンブリ(510)は、伝達用アセンブリ(512)、回転ノブ(514)、及び回転ノブ(514)に対して近位に延びるシャフト(520)を含む。回転ノブ(514)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(514)は、伝達用アセンブリ(512)をハンドルアセンブリ(540)及び/又はシャフト(520)に対して回転させるように操作可能である。エンドエフェクタ(図示せず)は、伝達用アセンブリ(512)の遠位端に連結される。エンドエフェクタは、本明細書の教示を考慮すれば当業者には明らかであるように、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び又は他のいずれかのエンドエフェクタ又はエンドエフェクタの組み合わせを含んでもよい。エンドエフェクタ(80)などの超音波エンドエフェクタの事例では、シャフト(520)を通るシャフト穴(図示せず)は、伝達用アセンブリ(512)のシャフト(520)からのハンドルアセンブリ(540)内部の構成要素への機械的な連結を可能とし、上述の組立形ハンドルアセンブリ(60)に類似する方法で構成されてもよい。エンドエフェクタ(200)等のRFエンドエフェクタの場合、シャフト穴は、伝達用アセンブリ(512)の一部が、少なくとも部分的にシャフト(520)を通って延びるのを可能にする。伝達用アセンブリ(512)は、ハンドルアセンブリ(540)からエンドエフェクタへ電気的連結を行うことができるように、シャフト(520)内部の補足的スリップリングコネクタに電気的に連結可能な内部スリップリングコネクタを具備してもよい。更にもう1つの代替例では、シャフト(520)を通り抜ける穴、及び/又は、エンドエフェクタアセンブリ(510)上の他の場所経由で流体連結を行うこともできる。
第4の例示的な連結機構(600)は、例示的なエンドエフェクタアセンブリ(610)のシャフト(620)の周りに配置されるネジ付きスリップナット(630)を含む(図8A〜8Bに図示)。本実施例において、エンドエフェクタアセンブリ(610)は、伝達用アセンブリ(612)、回転ノブ(614)、及び回転ノブ(614)に対して近位に延びるシャフト(620)を含む。回転ノブ(614)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(614)は、ハンドルアセンブリ(640)及び/又はシャフト(620)に対して伝達用アセンブリ(612)を回転させることができる。エンドエフェクタ(図示せず)は、伝達用アセンブリ(612)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。エンドエフェクタ(80)などの超音波エンドエフェクタの事例では、シャフト(620)を通るシャフト穴(図示せず)は、伝達用アセンブリ(612)のシャフト(620)からのハンドルアセンブリ(640)内部の構成要素への機械的な連結を可能とし、上述の組立形ハンドルアセンブリ(60)に類似する方法で構成されてもよい。エンドエフェクタ(200)等のRFエンドエフェクタの場合、シャフト穴は、伝達用アセンブリ(612)の一部が、少なくとも部分的にシャフト(620)を通って延びるのを可能にする。伝達用アセンブリ(612)は、ハンドルアセンブリ(640)からエンドエフェクタへ電気的連結を行うことができるような具合に、シャフト(620)内部の補足的スリップリングコネクタに電気的に連結することのできる内部スリップリングコネクタを具備することができる。更にもう1つの代替例では、シャフト(620)を通り抜ける穴によって、及び/又は、エンドエフェクタアセンブリ(610)上の他の場所に流体連結を行うこともできる。
第5の例示的な連結機構(700)は、例示的なエンドエフェクタアセンブリ(710)に対して1つ又は2つ以上のT形の挿入可能なコネクタ(734、736、738)を形成する、1つ又は2つ以上の周辺のフランジ(728、730、732)を有する1つ又は2つ以上のシャフト(722、724、726)を含む(図9A〜9Bに図示)。本実施例では、エンドエフェクタアセンブリ(710)は、伝達用アセンブリ(712)、回転ノブ(714)、回転ノブ(714)に対して近位に延びる1つ又は2つ以上のシャフト(722、724、726)を含む。回転ノブ(714)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(714)は、ハンドルアセンブリ(740)及び/又は1つ又は2つ以上のシャフト(722、724、726)に対して伝達用アセンブリ(712)を回転させるように操作可能である。エンドエフェクタ(図示せず)は、伝達用アセンブリ(712)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われる他の任意のエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。
第6の例示的な連結機構(800)は、ハンドルアセンブリ(840)内に配設され、かつ例示的なエンドエフェクタアセンブリ(810)のシャフト(820)の周辺のくぼみ(822)を係合するように構成された一対の弾性付勢されたボールベアリング部材(850)を含む(図10A〜10Bに図示)。本実施例では、エンドエフェクタアセンブリ(810)は、伝達用アセンブリ(812)、回転ノブ(814)、及び回転ノブ(814)に対して近位に延びるシャフト(820)を含む。回転ノブ(814)は、単に所望によるものであり、省略されることがあるということが理解されるべきである。回転ノブ(814)は、ハンドルアセンブリ(840)及び/又はシャフト(820)に対して伝達用アセンブリ(812)を回転させるように操作可能である。エンドエフェクタ(図示せず)は、伝達用アセンブリ(812)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。エンドエフェクタ(80)などの超音波エンドエフェクタの事例では、シャフト(820)を通るシャフト穴(図示せず)は、伝達用アセンブリ(812)のシャフト(820)からのハンドルアセンブリ(840)内部の構成要素への機械的な連結を可能とし、上述の組立形ハンドルアセンブリ(60)に類似する方法で構成されてもよい。エンドエフェクタ(200)等のRFエンドエフェクタの場合、シャフト穴は、伝達用アセンブリ(812)の一部が、シャフト(820)を通って少なくとも部分的に延びるのを可能にしてもよい。伝達用アセンブリ(812)は、ハンドルアセンブリ(840)からエンドエフェクタへ電気的連結を行うことができるように、シャフト(820)内部の補足的スリップリングコネクタに電気的に連結することのできる内部スリップリングコネクタを具備してもよい。例えば、ボールベアリング(852)は、下記で述べるように、電源に電気的に連結されてもよく、くぼみ(822)内で接点に連結してもよい。更にもう1つの代替例では、シャフト(820)を通り抜ける穴、及び/又は、エンドエフェクタアセンブリ(810)上の他の場所経由で流体連結を行ってもよい。
第7の例示的な連結機構(900)は、ハンドルアセンブリ(940)のケーシング(944)中のスロット(946)の中に挿入可能な挿入可能なロックキー(950)を含む。ロックキー(950)は、近位のアセンブリ(920)をケーシング(944)中の遠位開口部(942)から挿入するとき、図11A〜11Bに示す更に別の例示的なエンドエフェクタアセンブリ(910)の近位のアセンブリ(920)を長手方向に固定するように構成される。本実施例では、エンドエフェクタアセンブリ(910)は、伝達用アセンブリ(912)、伝達用アセンブリ(910)に連結されたギア(916)、及びギア(916)に近位の近位のアセンブリ(920)を含む。1つの単に例示的な構成では、近位のアセンブリ(920)は、上述のエンドエフェクタ(80)などの超音波エンドエフェクタと共に使用するための波型バネアセンブリを含む。あるいは、近位のアセンブリ(920)は、エンドエフェクタアセンブリ(910)の機械的構成要素を操作するために、図9A〜9Bを参照しながら説明したTコネクタ及びシャフトなどの作動可能な構成要素を含んでもよい。更になお、近位のアセンブリ(920)は、ゼネレータ(20)又はハンドルアセンブリ(940)内の電源などの電源にエンドエフェクタアセンブリ(910)を電気的に連結するために、電気接点を含んでもよい。更に別の代替例では、近位アセンブリ(920)及び/又は、エンドエフェクタアセンブリ(910)上の他の場所経由で流体連結を行ってもよい。上記のように、エンドエフェクタ(図示せず)は、伝達用アセンブリ(912)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。
第8の例示的な連結機構は、ハンドルアセンブリ(1100)の回転くぼみ(1110)の中に回転可能なようにロックするボルト部分(1040)の相対する側面から延びる一対のロックタブ(1050)を有するエンドエフェクタアセンブリ(1000)を含む(図12〜14に図示)。初めに図12を参照すると、エンドエフェクタアセンブリ(1000)は、伝達用アセンブリ(1010)、回転部分(1020)、及びボルト部分(1040)を含む。図12に断面で示すように、伝達用アセンブリ(1010)は回転部分(1020)に固定され、それから延びる。回転部分(1020)は単に所望によるものであり、伝達用アセンブリ(1010)は、ボルト部分(1040)に固定的に連結されてもよく、又は伝達用アセンブリ(1010)がボルト部分(1040)に対して回転してもよいように、連結されてもよいということが理解されるべきである。回転部分(1020)は、ハンドルアセンブリ(1100)及び/又はボルト部分(1040)に対して伝達用アセンブリ(1010)を回転させるように操作可能である、回転ノブ(1022)を含む。エンドエフェクタ(図示せず)は、伝達用アセンブリ(1010)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。図示する実施例では、電導性ワイヤ(1012)は伝達用アセンブリ(1010)から延び、エンドエフェクタアセンブリ(1000)の近位端の近くに位置する回転部分(1040)の外表面上に搭載された第1のスリップリング(1024)に連結される。
例示的な第1の電気的連結機構(1200)は、ハンドルアセンブリ(1240)内のネジ付きの部材(1250)の相補的なネジ(1252)の中にねじ込む、エンドエフェクタアセンブリ(1210)上の1つ又は2つ以上のネジ付きの電極(1230)を含む(図15に図示)。本実施例では、例示的なエンドエフェクタアセンブリ(1210)は、伝達用アセンブリ(1212)、回転ノブ(1214)、及び回転ノブ(1214)に対して近位に延びるシャフト(1220)を含む。回転ノブ(1214)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(1214)は、ハンドルアセンブリ(1240)及び/又はシャフト(1220)に対して伝達用アセンブリ(1212)を回転させるように操作可能である。エンドエフェクタ(図示せず)は、伝達用アセンブリ(1212)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。
例示的な第2の電気的連結機構(1300)は、図16に示すように、別の例示的なエンドエフェクタアセンブリ(1310)上の対応する接点(1322、1324)に接触し、電気的に連結するためにハンドルアセンブリ(1340)内に1つ又は2つ以上のバネ押し接点(1350)を含む。本実施例では、例示的なエンドエフェクタアセンブリ(1310)は、伝達用アセンブリ(1312)、回転ノブ(1314)、及び回転ノブ(1314)に対して近位に延びるシャフト(1320)を含む。回転ノブ(1314)は、単に所望によるものであり、省略されてもよいということが理解されるべきである。回転ノブ(1314)は、ハンドルアセンブリ(1340)及び/又はシャフト(1320)に対して伝達用アセンブリ(1312)を回転させるように操作可能である。エンドエフェクタ(図示せず)は、伝達用アセンブリ(1312)の遠位端に連結される。エンドエフェクタは、超音波エンドエフェクタ(80)、RFエンドエフェクタ(200)及び/又は本明細書の教示を考慮すれば当業者には明らかであると思われるような他のいずれかのエンドエフェクタ又は複数のエンドエフェクタの組み合わせを含んでもよい。
(1) 外科用器具であって、
(a)本体アセンブリであって、
i.トリガー、
ii.遠位端に形成される遠位開口部を有するケーシング、及び
iii.第1の連結アセンブリ部分を含む、本体アセンブリと、
(b)エンドエフェクタアセンブリであって、
i.近位のシャフト、
ii.前記近位のシャフトから遠位に延びる伝達用アセンブリ、
iii.前記伝達用アセンブリの遠位端に連結されるエンドエフェクタ、及び
iv.第2の連結アセンブリ部分を含む、エンドエフェクタアセンブリとを含み、
前記第2の連結アセンブリ部分が、前記遠位開口部の中に挿入可能であり、前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分に取り外し可能なように連結するように操作可能であり、前記エンドエフェクタアセンブリが、前記第2の連結アセンブリ部分に対する前記第1の連結アセンブリ部分の連結により、遠位に並進しないようにされている、外科用器具。
(2) 前記エンドエフェクタアセンブリが、前記伝達用アセンブリに連結され、かつ前記近位のシャフトに遠位に配設された回転可能なノブを更に含み、前記回転可能なノブが、前記本体アセンブリに対して前記伝達用アセンブリを回転させるように操作可能である、実施態様1に記載の外科用器具。
(3) 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、前記エンドエフェクタの作動可能な部分を前記本体アセンブリに機械的に連結するように操作可能である、実施態様1に記載の外科用器具。
(4) 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、前記エンドエフェクタの一部分を電源に電気的に連結するように操作可能である、実施態様1に記載の外科用器具。
(5) 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、
(a)前記エンドエフェクタの作動可能な部分を前記本体アセンブリに機械的に連結し、
(b)前記エンドエフェクタの一部分を電源に電気的に連結するように、
操作可能である、実施態様1に記載の外科用器具。
(7) 前記第1の連結アセンブリ部分が、前記ケーシングの1つ又は2つ以上の弾性付勢された部分を含み、前記第2の連結アセンブリ部分が、前記近位のシャフトから外側に延びる周辺の傾斜面を含む、実施態様1に記載の外科用器具。
(8) 前記第1の連結アセンブリ部分が、前記ケーシングの並進可能な部分を含み、前記第2の連結アセンブリ部分が、前記近位のシャフト上に環状フランジを含む、実施態様1に記載の外科用器具。
(9) 前記第1の連結アセンブリ部分が、前記ケーシング内でネジ付きの部材を含み、前記第2の連結アセンブリ部分が、前記近位のシャフトの周りに配設されたネジ付きのナットを含む、実施態様1に記載の外科用器具。
(10) 前記近位のシャフトが、1つ又は2つ以上のキー付き部分、及び前記近位のシャフトの近位端上に位置するフランジを含み、前記ネジ付きのナットが、前記フランジの遠位にスライド可能なように配設され、前記ネジ付きのナットがキー溝を含む、実施態様9に記載の外科用器具。
(12) 前記第1の連結アセンブリ部分が、ロックキーを含み、前記第2の連結アセンブリ部分が、前記伝達用アセンブリの近位のセグメントを含み、前記ケーシングが、前記ロックキーの一部分を受け入れるように構成されたスロットを含み、前記ロックキーが、前記伝達用アセンブリの前記近位のセグメントに連結し、前記近位のシャフトの遠位の並進を拘束する、実施態様1に記載の外科用器具。
(13) 前記本体アセンブリが、前記ロックキーの一部分を受け入れるように構成されたロックスロットを有するヨークアセンブリを含み、前記ロックキーを前記ロックスロットの中に挿入したときに、前記ヨークアセンブリが、前記近位のシャフトを近位で作動するように操作可能である、実施態様12に記載の外科用器具。
(14) 前記エンドエフェクタが超音波エンドエフェクタを含む、実施態様1に記載の外科用器具。
(15) 前記エンドエフェクタがRF電気外科用エンドエフェクタを含む、実施態様1に記載の外科用器具。
(a)本体アセンブリであって、
i.トリガー、
ii.遠位端に形成される遠位開口部を有するケーシング、及び
iii.前記遠位開口部の近位に配設される1つ又は2つ以上の回転くぼみを含む、本体アセンブリと、
(b)エンドエフェクタアセンブリであって、
i.外側に延びる1つ又は2つ以上のロックタブを有するボルト部分、
ii.前記ボルト部分に連結し、かつ前記ボルト部分から遠位に延びる伝達用アセンブリ、及び
iii.前記伝達用アセンブリの遠位端に連結したエンドエフェクタを含む、エンドエフェクタアセンブリとを含み、
前記1つ又は2つ以上のロックタブを有する前記ボルト部分の一部分が、前記ケーシングの前記遠位開口部を通じて挿入可能であり、前記ボルト部分が、前記1つ又は2つ以上のロックタブを回転させて前記1つ又は2つ以上の回転くぼみの中に入れるように操作可能である、外科用器具。
(17) 前記1つ又は2つ以上のロックタブが電気接点を含み、前記1つ又は2つ以上の回転くぼみが相補的な電気接点を含み、前記1つ又は2つ以上のロックタブを回転させて前記1つ又は2つ以上の回転くぼみの中に入れるとき、前記電気接点及び前記相補的な電気接点が、電気的に連結するように構成されている、実施態様16に記載の外科用器具。
(18) 前記エンドエフェクタアセンブリが、1つ又は2つ以上のインジケータを更に含み、前記本体アセンブリが、1つ又は2つ以上のセンサーを更に含み、前記エンドエフェクタアセンブリを前記本体アセンブリに連結させるとき、前記1つ又は2つ以上のセンサーが、前記1つ又は2つ以上のインジケータを認識するように操作可能である、実施態様16に記載の外科用器具。
(19) 前記エンドエフェクタアセンブリが、前記伝達用アセンブリに連結され、かつ前記本体アセンブリに対して前記伝達用アセンブリを回転させるように操作可能である、回転部分を更に含む、実施態様16に記載の外科用器具。
(20) 外科用器具であって、
(a)本体アセンブリと、
(b)エンドエフェクタアセンブリと、
(c)前記エンドエフェクタアセンブリを前記本体アセンブリに選択的に連結するように操作可能である、連結アセンブリとを含み、
前記連結アセンブリが、前記エンドエフェクタアセンブリを前記本体アセンブリに機械的に連結するように操作可能であり、
前記エンドエフェクタアセンブリが、前記本体アセンブリに対して長手方向に固定され、前記エフェクタアセンブリが、前記本体アセンブリに対して回転可能であり、
前記連結アセンブリが、前記エンドエフェクタアセンブリを電源に電気的に連結するように更に操作可能である、外科用器具。
Claims (20)
- 外科用器具であって、
(a)本体アセンブリであって、
i.トリガー、
ii.遠位端に形成される遠位開口部を有するケーシング、及び
iii.第1の連結アセンブリ部分を含む、本体アセンブリと、
(b)エンドエフェクタアセンブリであって、
i.近位のシャフト、
ii.前記近位のシャフトから遠位に延びる伝達用アセンブリ、
iii.前記伝達用アセンブリの遠位端に連結されるエンドエフェクタ、及び
iv.第2の連結アセンブリ部分を含む、エンドエフェクタアセンブリとを含み、
前記第2の連結アセンブリ部分が、前記遠位開口部の中に挿入可能であり、前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分に取り外し可能なように連結するように操作可能であり、前記エンドエフェクタアセンブリが、前記第2の連結アセンブリ部分に対する前記第1の連結アセンブリ部分の連結により、遠位に並進しないようにされている、外科用器具。 - 前記エンドエフェクタアセンブリが、前記伝達用アセンブリに連結され、かつ前記近位のシャフトに遠位に配設された回転可能なノブを更に含み、前記回転可能なノブが、前記本体アセンブリに対して前記伝達用アセンブリを回転させるように操作可能である、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、前記エンドエフェクタの作動可能な部分を前記本体アセンブリに機械的に連結するように操作可能である、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、前記エンドエフェクタの一部分を電源に電気的に連結するように操作可能である、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分が、前記第1の連結アセンブリ部分及び前記第2の連結アセンブリ部分を一緒に連結するときに、
(a)前記エンドエフェクタの作動可能な部分を前記本体アセンブリに機械的に連結し、
(b)前記エンドエフェクタの一部分を電源に電気的に連結するように、
操作可能である、請求項1に記載の外科用器具。 - 第1の連結機構部分が、前記ケーシングの一部分を含み、第2の連結機構部分が、前記近位のシャフトから外側に延びる1つ又は2つ以上の弾性タブを含む、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分が、前記ケーシングの1つ又は2つ以上の弾性付勢された部分を含み、前記第2の連結アセンブリ部分が、前記近位のシャフトから外側に延びる周辺の傾斜面を含む、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分が、前記ケーシングの並進可能な部分を含み、前記第2の連結アセンブリ部分が、前記近位のシャフト上に環状フランジを含む、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分が、前記ケーシング内でネジ付きの部材を含み、前記第2の連結アセンブリ部分が、前記近位のシャフトの周りに配設されたネジ付きのナットを含む、請求項1に記載の外科用器具。
- 前記近位のシャフトが、1つ又は2つ以上のキー付き部分、及び前記近位のシャフトの近位端上に位置するフランジを含み、前記ネジ付きのナットが、前記フランジの遠位にスライド可能なように配設され、前記ネジ付きのナットがキー溝を含む、請求項9に記載の外科用器具。
- 前記第1の連結アセンブリ部分が、1つ又は2つ以上の弾性付勢されたベアリング部材を含み、前記第2の連結機構部分が、前記近位のシャフトの一部分中に形成された周辺のくぼみを含む、請求項1に記載の外科用器具。
- 前記第1の連結アセンブリ部分が、ロックキーを含み、前記第2の連結アセンブリ部分が、前記伝達用アセンブリの近位のセグメントを含み、前記ケーシングが、前記ロックキーの一部分を受け入れるように構成されたスロットを含み、前記ロックキーが、前記伝達用アセンブリの前記近位のセグメントに連結し、前記近位のシャフトの遠位の並進を拘束する、請求項1に記載の外科用器具。
- 前記本体アセンブリが、前記ロックキーの一部分を受け入れるように構成されたロックスロットを有するヨークアセンブリを含み、前記ロックキーを前記ロックスロットの中に挿入したときに、前記ヨークアセンブリが、前記近位のシャフトを近位で作動するように操作可能である、請求項12に記載の外科用器具。
- 前記エンドエフェクタが超音波エンドエフェクタを含む、請求項1に記載の外科用器具。
- 前記エンドエフェクタがRF電気外科用エンドエフェクタを含む、請求項1に記載の外科用器具。
- 外科用器具であって、
(a)本体アセンブリであって、
i.トリガー、
ii.遠位端に形成される遠位開口部を有するケーシング、及び
iii.前記遠位開口部の近位に配設される1つ又は2つ以上の回転くぼみを含む、本体アセンブリと、
(b)エンドエフェクタアセンブリであって、
i.外側に延びる1つ又は2つ以上のロックタブを有するボルト部分、
ii.前記ボルト部分に連結し、かつ前記ボルト部分から遠位に延びる伝達用アセンブリ、及び
iii.前記伝達用アセンブリの遠位端に連結したエンドエフェクタを含む、エンドエフェクタアセンブリとを含み、
前記1つ又は2つ以上のロックタブを有する前記ボルト部分の一部分が、前記ケーシングの前記遠位開口部を通じて挿入可能であり、前記ボルト部分が、前記1つ又は2つ以上のロックタブを回転させて前記1つ又は2つ以上の回転くぼみの中に入れるように操作可能である、外科用器具。 - 前記1つ又は2つ以上のロックタブが電気接点を含み、前記1つ又は2つ以上の回転くぼみが相補的な電気接点を含み、前記1つ又は2つ以上のロックタブを回転させて前記1つ又は2つ以上の回転くぼみの中に入れるとき、前記電気接点及び前記相補的な電気接点が、電気的に連結するように構成されている、請求項16に記載の外科用器具。
- 前記エンドエフェクタアセンブリが、1つ又は2つ以上のインジケータを更に含み、前記本体アセンブリが、1つ又は2つ以上のセンサーを更に含み、前記エンドエフェクタアセンブリを前記本体アセンブリに連結させるとき、前記1つ又は2つ以上のセンサーが、前記1つ又は2つ以上のインジケータを認識するように操作可能である、請求項16に記載の外科用器具。
- 前記エンドエフェクタアセンブリが、前記伝達用アセンブリに連結され、かつ前記本体アセンブリに対して前記伝達用アセンブリを回転させるように操作可能である、回転部分を更に含む、請求項16に記載の外科用器具。
- 外科用器具であって、
(a)本体アセンブリと、
(b)エンドエフェクタアセンブリと、
(c)前記エンドエフェクタアセンブリを前記本体アセンブリに選択的に連結するように操作可能である、連結アセンブリとを含み、
前記連結アセンブリが、前記エンドエフェクタアセンブリを前記本体アセンブリに機械的に連結するように操作可能であり、
前記エンドエフェクタアセンブリが、前記本体アセンブリに対して長手方向に固定され、前記エフェクタアセンブリが、前記本体アセンブリに対して回転可能であり、
前記連結アセンブリが、前記エンドエフェクタアセンブリを電源に電気的に連結するように更に操作可能である、外科用器具。
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CN103298419A (zh) | 2013-09-11 |
EP2635205A1 (en) | 2013-09-11 |
US10945783B2 (en) | 2021-03-16 |
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US9308009B2 (en) | 2016-04-12 |
CA2816899A1 (en) | 2012-05-10 |
US10376304B2 (en) | 2019-08-13 |
US9510895B2 (en) | 2016-12-06 |
CN103298419B (zh) | 2016-06-22 |
US20120116388A1 (en) | 2012-05-10 |
US20170042569A1 (en) | 2017-02-16 |
AU2011323281A1 (en) | 2013-05-23 |
US20120116266A1 (en) | 2012-05-10 |
WO2012061640A1 (en) | 2012-05-10 |
US20120116395A1 (en) | 2012-05-10 |
JP5992425B2 (ja) | 2016-09-14 |
US20200078084A1 (en) | 2020-03-12 |
US8998939B2 (en) | 2015-04-07 |
AU2011323281B2 (en) | 2015-12-17 |
EP2635205B1 (en) | 2018-02-21 |
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