JP2016508416A - 外科用器具のエンドエフェクタのためのつかみ具閉鎖機構 - Google Patents
外科用器具のエンドエフェクタのためのつかみ具閉鎖機構 Download PDFInfo
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Abstract
Description
図1〜図7は、外科的処置を行うために、図1に描写されるような非関節動作状態で、トロカールカニューレを通って患者内の手術部位まで挿入するように寸法決めされている、例示の外科用ステープル留め及び切断器具(10)を示している。単なる例示として、患者の腹部内に、患者の2本の肋骨の間に、又はその他の部位に、かかるトロカールを挿入してもよい。一部の状況では、器具(10)は、トロカールなしで使用される。例えば、開胸又は他の種類の切開によって、器具(10)を直接挿入してもよい。本発明の例の器具(10)は、シャフト(22)に結合しているハンドル部分(20)を含む。シャフト(22)は、関節動作ジョイント(11)内で遠位方向に終端し、関節動作ジョイント(11)は、エンドエフェクタ(12)と更に連結されている。本明細書では、「近位」及び「遠位」といった用語は、器具(10)のハンドル部分(20)を握っている臨床医を基準として使用されていることを理解されたい。したがって、エンドエフェクタ(12)は、より近位にあるハンドル部分(20)に対して遠位である。便宜上、また説明を明確にするため、本明細書では「垂直」及び「水平」といった空間的な用語を図面に対して使用する点も更に認識されるであろう。しかしながら、外科用器具は、多くの配向及び姿勢で使用され、これらの用語は、制限的かつ絶対的でないことが意図されている。
本発明の例では、器具(10)は、発射ビーム(14)の電動制御を提供する。図8〜図11は、発射ビーム(14)の電動制御を提供するために使用されてもよい、例示の構成要素を示す。特に、図8は、電池パック(104)(図1及び図2にも図示)からの電力を電動モーター(102)に供給するために使用されてもよい、例示の制御回路(100)を示す。以下で更に詳細に説明されるように、電動モーター(102)は、発射ビーム(14)を長手方向に移動させるように動作可能である。モーター(102)及び電池パック(104)を含む制御回路(100)全体を、ハンドル部分(20)内に収容することが可能であることを理解されたい。図8は、オープンスイッチとして発射トリガー(28)を示しているが、このスイッチは、発射トリガー(28)が作動しているときは閉じられていることを理解されたい。この例の回路(100)はまた、回路(100)を完了するために閉じられなければならない安全スイッチ(106)を含むが、安全スイッチ(106)は単なる任意選択的な構成要素であることを理解されたい。安全スイッチ(106)は、別装のボタン、スライダ、又はハンドル部分(20)の他の機構を作動することによって閉じることができる。
場合によっては、閉鎖時に、エンドエフェクタ(12)の機械的負荷能力を増大させることが望まれ得る。例えば、機械的負荷能力の増大は、肉厚組織又は密組織をステープル留めするために望まれ得る。機械的負荷能力の増大はまた、つかみ具(16、18)の間の不用意な運動を減少又は排除し得る。したがって、傾斜面係合機構は、機械的負荷能力を増大させるために、エンドエフェクタ(12)上に設けられてもよい。以下の例は、エンドエフェクタ(12)に容易に導入することができる傾斜面係合機構の、単なる例示としてのいくつかの形態を含む。
図12は、器具(10)内に容易に組み込むことができる例示のエンドエフェクタ(212)を示す。エンドエフェクタ(212)は、下部つかみ具(216)、枢動可能アンビル(218)、及び閉鎖用リング(233)を備える。下部つかみ具(216)は、エンドエフェクタ(12)の下部つかみ具(16)と類似している。枢動可能アンビル(218)は、枢動可能アンビル(218)がエンドエフェクタ(212)の機械的負荷能力を増大させるために閉鎖用リング(233)に対応する傾斜面係合機構を備えていることを除き、枢動可能アンビル(18)と類似している。エンドエフェクタ(212)の閉鎖用リング(233)は、閉鎖用リング(233)が延伸部(230)を備えていることを除き、閉鎖用リング(33)と類似している。
図20は、器具(10)に容易に組み込むことができる、その他の例示のエンドエフェクタ(312)を示す。エンドエフェクタ(312)は、枢動可能アンビル(318)、下部つかみ具(316)、及び閉鎖用リング(333)を備える。枢動可能アンビル(318)は、図21に示すように、枢動可能アンビル(318)がフランジ(319)から内側に延在している突起(317)を備えていることを除き、枢動可能アンビル(18)と類似している。突起(317)の表面は、傾斜付けられ、突起(317)が下部つかみ具(316)に対して進む助けとなる。下部つかみ具(316)は、図22に示すように、下部つかみ具(316)が下部つかみ具(316)の各外面上にチャネル(320)を備えていることを除き、エンドエフェクタ(12)の下部つかみ具(16)と類似している。チャネル(320)は、アンビル(318)の突起(317)に対応するように寸法決めされている。チャネル(320)は、チャネル(320)の底面にあるより狭い開口部へと遠位に角度付けられたチャネル(320)の上面にある広い開口部を備える。チャネル(320)の遠位縁は、上部垂直壁部(321)、垂直壁部(321)から遠位に延在している傾斜壁部(323)、及び傾斜壁部(323)から下向きに延在している下部垂直壁部(326)を備える。チャネル(320)の近位縁は、水平壁部(322)に隣接する垂直壁部(328)、及び傾斜壁部(324)を備える。壁部(321、323)は、アンビル(318)が下部つかみ具(316)に対して移動する際、チャネル(320)を介して突起(317)を誘導するように構成され、これにより、下部つかみ具(316)に対してアンビル(318)を開放かつ/又は閉鎖するように構成されている。下部つかみ具(316)は、アンビル(318)が下部つかみ具(316)に対して枢動可能となるように、アンビル(318)のピン(327)を受け入れる開口部(329)を備える。この例において、開口部(329)は、細長スロットである。それゆえに、ピン(327)は、開口部(329)内で自身の軸を中心に枢動することに加え、開口部(329)に沿ってスライドすることを理解されたい。この動きもまた、たとえ枢軸がピン(327)と共に開口部(329)に沿って移動し、定位置にはなかったとしても、本明細書にて定義されている「枢動している(pivoting)」として見なされてもよい。閉鎖用リング(333)は、閉鎖用リング(33)と類似している。
本明細書で述べる教示、表現、実施形態、実施例などのうちのいずれか1つ又は2つ以上は、本明細書で述べるその他の教示、表現、実施形態、実施例などのうちいずれか1つ又は2つ以上と組み合わせることができることを理解されたい。したがって、上記の教示、表現、実施形態、実施例などは、互いに対して分離して考慮されるべきではない。本明細書の教示を組み合わせることができる種々の好適な方法は、本明細書の教示を考慮することで当業者には明らかであろう。かかる修正及び変形は、特許請求の範囲内に含まれることを意図する。
(1) 外科用器具での使用のためのエンドエフェクタであって、該エンドエフェクタは、
(a)第1のつかみ具と、
(b)該第1のつかみ具に対して枢動可能な第2のつかみ具であって、該第2のつかみ具は、近位端を備え、該近位端は、第1の係合機構及び第2の係合機構を備え、該第2の係合機構は、該第1の係合機構より遠位にある、第2のつかみ具と、
(c)該第2のつかみ具と連結されている閉鎖用リングであって、該閉鎖用リングは、該第1のつかみ具に対して移動可能であり、該閉鎖用リングは、該閉鎖用リングが該第1のつかみ具に対して遠位に移動する際、まず該第1の係合機構と係合し、次いで該第2のつかみ具の該第2の係合機構と係合するように構成され、それにより、該第1のつかみ具に対して該第2のつかみ具を枢動させる、閉鎖用リングと、を備える、エンドエフェクタ。
(2) 前記第1の係合機構は、前記第2のつかみ具の前記近位端の中央部分上に第1の傾斜表面を備える、実施態様1に記載のエンドエフェクタ。
(3) 前記第2の係合機構は、前記第2のつかみ具の前記近位端の少なくとも1つの側部分上に第2の傾斜表面を備える、実施態様2に記載のエンドエフェクタ。
(4) 前記第2のつかみ具の前記近位端は、第1の側部分及び第2の側部分を有し、該第2の側部分は、該第1の側部分の反対側にあり、
前記第2の傾斜表面は、前記第2のつかみ具の前記近位端の該第1の側部分上に位置付けられ、
前記第2の係合機構は、第3の傾斜表面を更に備え、該第3の傾斜表面は、前記第2のつかみ具の前記近位端の該第2の側部分上に位置付けられている、実施態様3に記載のエンドエフェクタ。
(5) 前記閉鎖用リングは、前記閉鎖用リングが遠位に移動する際、前記第1の係合機構から前記第2の係合機構へと機械的負荷を伝達するように構成されている、実施態様3に記載のエンドエフェクタ。
(7) 前記壁部は、湾曲形状を備える、実施態様6に記載のエンドエフェクタ。
(8) 前記閉鎖用リングの遠位端は、壁部を備え、前記閉鎖用リングの該壁部は、前記閉鎖用リングが前記第1の係合機構及び第2の係合機構に係合した後に、前記第2のつかみ具の前記第3の係合機構に係合するように構成されている、実施態様6に記載のエンドエフェクタ。
(9) 前記閉鎖用リングは、前記閉鎖用リングが遠位に移動する際、前記第2の係合機構から前記第3の係合機構へと機械的負荷を伝達するように構成されている、実施態様8に記載のエンドエフェクタ。
(10) 前記第2のつかみ具は、傾斜表面を備え、該傾斜表面は、前記第2のつかみ具の前記近位端の側で、近位に下向きに傾斜する、実施態様1に記載のエンドエフェクタ。
(12) 前記閉鎖用リングの前記突起は、前記閉鎖用リングが遠位位置から近位位置へと移動する際、前記第2のつかみ具の前記傾斜表面に沿って移動するように構成され、前記閉鎖用リングは、前記閉鎖用リングが該遠位位置から該近位位置へと移動する際、前記第2のつかみ具を前記第1のつかみ具から離れるように枢動させるように動作可能である、実施態様11に記載のエンドエフェクタ。
(13) シャフトを更に備え、前記エンドエフェクタは、該シャフトに連結され、該シャフトは、前記エンドエフェクタ及び該シャフトが長手方向に整列している第1の位置から、前記エンドエフェクタの長手方向軸線が該シャフトの長手方向軸線に対して斜めに配向されている第2の位置まで、前記エンドエフェクタを移動させるように動作可能である関節動作機構を備える、実施態様12に記載のエンドエフェクタ。
(14) ハンドル部分を更に備え、該ハンドル部分は、前記シャフトに連結され、該ハンドル部分は、前記閉鎖用リングを移動させるように動作可能なアクチュエータを備える、実施態様13に記載のエンドエフェクタ。
(15) 前記エンドエフェクタは、前記第1のつかみ具と前記第2のつかみ具との間の組織をステープル留めするように動作可能である、実施態様1に記載のエンドエフェクタ。
(a)第1のつかみ具であって、該第1のつかみ具の近位部分の側面上に横向きのチャネルを備える、第1のつかみ具と、
(b)該第1のつかみ具に対して枢動可能な第2のつかみ具であって、該第2のつかみ具は、内側に延在している突起を備え、該突起は、該第1のつかみ具の該チャネル内を移動するように構成されている、第2のつかみ具と、
(c)該第2のつかみ具に係合するように構成されている閉鎖用リングであって、該閉鎖用リングは、近位位置から遠位位置へと移動可能であり、該閉鎖用リングは、該チャネルに沿って該突起を駆動させるように動作可能であり、それにより、該第1のつかみ具に対して該第2のつかみ具を枢動させる、閉鎖用リングと、を備える、エンドエフェクタ。
(17) 前記突起は、カム表面を備える、実施態様16に記載のエンドエフェクタ。
(18) 前記チャネルは、遠位方向に下向きに傾斜している傾斜表面を備え、前記第1のつかみ具は、前記閉鎖用リングが前記遠位位置へと移動する際、前記第2のつかみ具に向かって枢動するように構成されている、実施態様16に記載のエンドエフェクタ。
(19) 前記チャネルの前記傾斜表面は、遠位方向に減少する角度(decreased angle)で傾斜する、実施態様18に記載のエンドエフェクタ。
(20) エンドエフェクタを閉鎖するための方法であって、該エンドエフェクタは、第1のつかみ具と、該第1のつかみ具に対して枢動可能な第2のつかみ具と、閉鎖用リングと、を備え、該第2のつかみ具の近位端は、第1の傾斜表面及び第2の傾斜表面を備え、該方法は、
(a)該閉鎖用リングが、該第1の傾斜表面に係合し、該第2のつかみ具を該第1のつかみ具に向かって枢動させるように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に移動させる工程と、
(b)該閉鎖用リングが、該第2の傾斜表面に係合し、該第2のつかみ具を該第1のつかみ具に向かって枢動させるように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に更に移動させる工程と、
(c)該閉鎖用リングが、該第1の傾斜表面から上向きに延在している壁部に係合し、該閉鎖用リングが、閉鎖位置において該第2のつかみ具を維持するように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に更に移動させる工程と、を含む、方法。
Claims (20)
- 外科用器具での使用のためのエンドエフェクタであって、該エンドエフェクタは、
(a)第1のつかみ具と、
(b)該第1のつかみ具に対して枢動可能な第2のつかみ具であって、該第2のつかみ具は、近位端を備え、該近位端は、第1の係合機構及び第2の係合機構を備え、該第2の係合機構は、該第1の係合機構より遠位にある、第2のつかみ具と、
(c)該第2のつかみ具と連結されている閉鎖用リングであって、該閉鎖用リングは、該第1のつかみ具に対して移動可能であり、該閉鎖用リングは、該閉鎖用リングが該第1のつかみ具に対して遠位に移動する際、まず該第1の係合機構と係合し、次いで該第2のつかみ具の該第2の係合機構と係合するように構成され、それにより、該第1のつかみ具に対して該第2のつかみ具を枢動させる、閉鎖用リングと、を備える、エンドエフェクタ。 - 前記第1の係合機構は、前記第2のつかみ具の前記近位端の中央部分上に第1の傾斜表面を備える、請求項1に記載のエンドエフェクタ。
- 前記第2の係合機構は、前記第2のつかみ具の前記近位端の少なくとも1つの側部分上に第2の傾斜表面を備える、請求項2に記載のエンドエフェクタ。
- 前記第2のつかみ具の前記近位端は、第1の側部分及び第2の側部分を有し、該第2の側部分は、該第1の側部分の反対側にあり、
前記第2の傾斜表面は、前記第2のつかみ具の前記近位端の該第1の側部分上に位置付けられ、
前記第2の係合機構は、第3の傾斜表面を更に備え、該第3の傾斜表面は、前記第2のつかみ具の前記近位端の該第2の側部分上に位置付けられている、請求項3に記載のエンドエフェクタ。 - 前記閉鎖用リングは、前記閉鎖用リングが遠位に移動する際、前記第1の係合機構から前記第2の係合機構へと機械的負荷を伝達するように構成されている、請求項3に記載のエンドエフェクタ。
- 前記第2のつかみ具の前記近位端は、第3の係合機構を備え、該第3の係合機構は、前記第1の傾斜表面の遠位端から上向きに延在している壁部を備える、請求項3に記載のエンドエフェクタ。
- 前記壁部は、湾曲形状を備える、請求項6に記載のエンドエフェクタ。
- 前記閉鎖用リングの遠位端は、壁部を備え、前記閉鎖用リングの該壁部は、前記閉鎖用リングが前記第1の係合機構及び第2の係合機構に係合した後に、前記第2のつかみ具の前記第3の係合機構に係合するように構成されている、請求項6に記載のエンドエフェクタ。
- 前記閉鎖用リングは、前記閉鎖用リングが遠位に移動する際、前記第2の係合機構から前記第3の係合機構へと機械的負荷を伝達するように構成されている、請求項8に記載のエンドエフェクタ。
- 前記第2のつかみ具は、傾斜表面を備え、該傾斜表面は、前記第2のつかみ具の前記近位端の側で、近位に下向きに傾斜する、請求項1に記載のエンドエフェクタ。
- 前記閉鎖用リングは、上向きに延在している突起を備え、該突起は、前記第2のつかみ具の前記傾斜表面に係合するように構成されている、請求項10に記載のエンドエフェクタ。
- 前記閉鎖用リングの前記突起は、前記閉鎖用リングが遠位位置から近位位置へと移動する際、前記第2のつかみ具の前記傾斜表面に沿って移動するように構成され、前記閉鎖用リングは、前記閉鎖用リングが該遠位位置から該近位位置へと移動する際、前記第2のつかみ具を前記第1のつかみ具から離れるように枢動させるように動作可能である、請求項11に記載のエンドエフェクタ。
- シャフトを更に備え、前記エンドエフェクタは、該シャフトに連結され、該シャフトは、前記エンドエフェクタ及び該シャフトが長手方向に整列している第1の位置から、前記エンドエフェクタの長手方向軸線が該シャフトの長手方向軸線に対して斜めに配向されている第2の位置まで、前記エンドエフェクタを移動させるように動作可能である関節動作機構を備える、請求項12に記載のエンドエフェクタ。
- ハンドル部分を更に備え、該ハンドル部分は、前記シャフトに連結され、該ハンドル部分は、前記閉鎖用リングを移動させるように動作可能なアクチュエータを備える、請求項13に記載のエンドエフェクタ。
- 前記エンドエフェクタは、前記第1のつかみ具と前記第2のつかみ具との間の組織をステープル留めするように動作可能である、請求項1に記載のエンドエフェクタ。
- 外科用器具での使用のためのエンドエフェクタであって、該エンドエフェクタは、
(a)第1のつかみ具であって、該第1のつかみ具の近位部分の側面上に横向きのチャネルを備える、第1のつかみ具と、
(b)該第1のつかみ具に対して枢動可能な第2のつかみ具であって、該第2のつかみ具は、内側に延在している突起を備え、該突起は、該第1のつかみ具の該チャネル内を移動するように構成されている、第2のつかみ具と、
(c)該第2のつかみ具に係合するように構成されている閉鎖用リングであって、該閉鎖用リングは、近位位置から遠位位置へと移動可能であり、該閉鎖用リングは、該チャネルに沿って該突起を駆動させるように動作可能であり、それにより、該第1のつかみ具に対して該第2のつかみ具を枢動させる、閉鎖用リングと、を備える、エンドエフェクタ。 - 前記突起は、カム表面を備える、請求項16に記載のエンドエフェクタ。
- 前記チャネルは、遠位方向に下向きに傾斜している傾斜表面を備え、前記第1のつかみ具は、前記閉鎖用リングが前記遠位位置へと移動する際、前記第2のつかみ具に向かって枢動するように構成されている、請求項16に記載のエンドエフェクタ。
- 前記チャネルの前記傾斜表面は、遠位方向に減少する角度で傾斜する、請求項18に記載のエンドエフェクタ。
- エンドエフェクタを閉鎖するための方法であって、該エンドエフェクタは、第1のつかみ具と、該第1のつかみ具に対して枢動可能な第2のつかみ具と、閉鎖用リングと、を備え、該第2のつかみ具の近位端は、第1の傾斜表面及び第2の傾斜表面を備え、該方法は、
(a)該閉鎖用リングが、該第1の傾斜表面に係合し、該第2のつかみ具を該第1のつかみ具に向かって枢動させるように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に移動させる工程と、
(b)該閉鎖用リングが、該第2の傾斜表面に係合し、該第2のつかみ具を該第1のつかみ具に向かって枢動させるように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に更に移動させる工程と、
(c)該閉鎖用リングが、該第1の傾斜表面から上向きに延在している壁部に係合し、該閉鎖用リングが、閉鎖位置において該第2のつかみ具を維持するように、該閉鎖用リングを該第1のつかみ具に対して遠位方向に更に移動させる工程と、を含む、方法。
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- 2014-02-13 MX MX2015011215A patent/MX360764B/es active IP Right Grant
- 2014-02-13 RU RU2015141075A patent/RU2650041C2/ru not_active IP Right Cessation
- 2014-02-13 WO PCT/US2014/016208 patent/WO2014133774A2/en active Application Filing
- 2014-02-13 JP JP2015560201A patent/JP6495188B2/ja active Active
- 2014-02-13 CN CN201480010834.9A patent/CN105007834B/zh active Active
- 2014-02-28 EP EP14157370.9A patent/EP2772201B1/en active Active
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JP2020501823A (ja) * | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | 外科用器具のジョーに閉鎖運動を加えるための、軸方向に移動可能な閉鎖システム機構 |
JP2020501785A (ja) * | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | 正の顎部開口機構を有する外科用器具 |
JP2020501752A (ja) * | 2016-12-21 | 2020-01-23 | エシコン エルエルシーEthicon LLC | エンドエフェクタジョーを開閉するために2つの別個の協働開放機構を有する外科用エンドエフェクタ |
JP7080891B2 (ja) | 2016-12-21 | 2022-06-06 | エシコン エルエルシー | 正の顎部開口機構を有する外科用器具 |
JP7106541B2 (ja) | 2016-12-21 | 2022-07-26 | エシコン エルエルシー | エンドエフェクタジョーを開閉するために2つの別個の協働開放機構を有する外科用エンドエフェクタ |
JP2021522891A (ja) * | 2018-05-11 | 2021-09-02 | ボルダー サージカル,リミティド ライアビリティ カンパニー | 外科手術器具及び関連する方法 |
JP7457656B2 (ja) | 2018-05-11 | 2024-03-28 | ボルダー サージカル,リミティド ライアビリティ カンパニー | 外科手術器具及び関連する方法 |
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US20140239036A1 (en) | 2014-08-28 |
WO2014133774A2 (en) | 2014-09-04 |
EP2772201B1 (en) | 2021-08-04 |
CN105007834A (zh) | 2015-10-28 |
WO2014133774A3 (en) | 2014-12-31 |
CA2903128A1 (en) | 2014-09-04 |
CA2903128C (en) | 2021-03-02 |
CN105007834B (zh) | 2017-10-20 |
RU2015141075A3 (ja) | 2018-03-01 |
BR112015020509A2 (pt) | 2017-07-18 |
EP2772201A2 (en) | 2014-09-03 |
RU2650041C2 (ru) | 2018-04-06 |
US9839421B2 (en) | 2017-12-12 |
PL2772201T3 (pl) | 2021-12-20 |
MX360764B (es) | 2018-11-15 |
MX2015011215A (es) | 2016-04-28 |
JP6495188B2 (ja) | 2019-04-03 |
BR112015020509B1 (pt) | 2022-04-19 |
EP2772201A3 (en) | 2014-11-12 |
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