JP2016537130A - 外科用器具のシャフトアセンブリを器具本体と結合する特徴部 - Google Patents
外科用器具のシャフトアセンブリを器具本体と結合する特徴部 Download PDFInfo
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Abstract
Description
図1は、例示の超音波外科用器具(10)を示す。器具(10)の少なくとも一部は、下記特許の教示の少なくとも一部にしたがって構築し、操作することができる:米国特許第5,322,055号、米国特許第5,873,873号、米国特許第5,980,510号、米国特許第6,325,811号、米国特許第6,773,444号、米国特許第6,783,524号、米国特許出願公開第2006/0079874号、米国特許出願公開第2007/0191713号、米国特許出願公開第2007/0282333号、米国特許出願公開第2008/0200940号、米国特許出願公開第2009/0105750号、米国特許出願公開第2010/0069940号、米国特許出願公開第2011/0015660号、米国特許出願公開第2012/0112687号、米国特許出願公開第2012/0116265号、米国特許出願第13/538,588号、米国特許出願第13/657,553号、米国特許出願第61/410,603号、及び/又は米国特許出願第14/028,717号。前述の特許、公開、及び出願のそれぞれの開示内容は、参照により本明細書に組み込まれる。その中に記載され、以下により詳細に記載されるように、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。また、器具(10)がHARMONIC ACE(登録商標)Ultrasonic Shears、HARMONIC WAVE(登録商標)Ultrasonic Shears、HARMONIC FOCUS(登録商標)Ultrasonic Shears、及び/又はHARMONIC SYNERGY(登録商標)Ultrasonic Bladesとの様々な構造的及び機能的な類似点を有し得ることを理解されたい。更に、器具(10)は、本明細書で引用され参照されることによって本明細書に組み込まれる他の参照文献のいずれかに教示される装置と、様々な構造的かつ機能的類似点を有することがある。
器具(10)の一部の変更形態は、トランスデューサアセンブリ(12)に対するシャフトアセンブリ(30)の手作業による回転を介してトランスデューサアセンブリ(12)との導波管(102)の選択的な結合を提供し、該回転では、オペレータは、シャフトアセンブリ(30)を回転させている間にトランスデューサアセンブリ(12)及びハンドルアセンブリ(20)を静止した状態に保つことが必要であり得る。器具(10)のそのような変更形態において、オペレータは、導波管(102)及びトランスデューサアセンブリ(12)の適切な接続性を確保するためにシャフトアセンブリ(30)に適切な量のトルクを手作業で印加することが必要であり得る。したがって、トランスデューサアセンブリ(12)との導波管(102)の結合を自動化するアセンブリを提供することが望ましい場合がある。例えば、1つの特徴部は、モータがトランスデューサアセンブリ(12)を回転させている間にハンドルアセンブリ(20)に対するシャフトアセンブリ(30)を選択的に固定し、それによって、導波管(102)をトランスデューサアセンブリ(12)と螺合可能に結合し得る。そのような特徴部を含む器具の様々な例示的な例を以下で更に詳細に説明するが、他の実施例が、本明細書の教示に鑑みれば当業者に明らかになろう。実施例は、様々な教示が以下で当業者に明らかになるように、上記の様々な教示と容易に組み合わせることができるように器具(10)の変形例と考えられ得ることを理解されたい。
図9A〜図9E及び図11A〜図11Eは、トランスデューサアセンブリ(12)を機械的に回転させ、それによって導波管(236)をトランスデューサアセンブリ(12)と螺合可能に結合するモータ(250)を有する器具(210)の実施例を示す。図8は、シャフトアセンブリ(230)をハンドルアセンブリ(220)に、導波管(236)をトランスデューサアセンブリ(12)に装着する例示的なプロセスを示す。図10は、シャフトアセンブリ(230)をハンドルアセンブリ(220)から、導波管(236)をトランスデューサアセンブリ(12)から除去する例示的なプロセスを示す。本実施例の器具(210)は、以下で論じる違いを除き上述の器具(10)と実質的に同様に操作するように構成される。特に、器具(210)は、ピボット式クランプアーム(図示せず)と超音波ブレード(図示せず)との間で手術部位にて組織を締着し、それによって組織を切断及び/又は封止するように構成される。
図13A〜図13E及び図15A〜図15Eは、トランスデューサアセンブリ(12)を機械的に回転させ、それによって導波管(336)をトランスデューサアセンブリ(12)と螺合可能に結合するモータ(350)を有する例示的な代替器具(310)を示す。図12は、シャフトアセンブリ(330)をハンドルアセンブリ(320)に、導波管(336)をトランスデューサアセンブリ(12)に装着する例示的なプロセスを示す。図14は、シャフトアセンブリ(330)をハンドルアセンブリ(320)から、導波管(336)をトランスデューサアセンブリ(12)から除去する例示的なプロセスを示す。本実施例の器具(310)は、以下で論じる違いを除き先に論じた器具(10、210)と実質的に同様に操作するように構成される。特に、器具(310)は、ピボット式クランプアーム(図示せず)と超音波ブレード(図示せず)との間で手術部位にて組織を締着し、それによって組織を切断及び/又は封止するように構成される。
上述のシャフトアセンブリ(230)は、長手方向に導かれた力に応じてそれぞれのハンドルアセンブリ(220、230)から分離される。特に、シャフトアセンブリ(230)は、本体部分(238)及びノブ(240)を遠位に長手方向に引き寄せることによってハンドルアセンブリ(220)から分離され、一方、シャフトアセンブリ(330)は、カラー(339)を遠位に長手方向に引き寄せることによってハンドルアセンブリ(320)から分離される。器具(210、310)の一部の変更形態において、シャフトアセンブリ(230,330)の少なくとも一部に掛かる長手方向に配向された力とシャフトアセンブリ(230、330)の少なくとも一部に掛かる側方に配向された力を区別する特徴部を提供することが望ましいであろう。本明細書で使用するとき、「側方に配向された力」などの用語は、シャフトアセンブリ(230、330)の長手軸に必ずしも垂直に配向される力に限定されることを意図するものではない。その代わりに、「側方に配向された力」などの用語は、シャフトアセンブリ(230、330)の長手軸に対して斜めに配向される力を含め、若干の側方又は横方向の成分を有する力を含むことが意図されている。更に、側方に配向された力に応じてハンドルアセンブリ(230、320)からのシャフトアセンブリ(230、330)の除去を防止する特徴部を提供し、その結果、シャフトアセンブリ(230、330)がシャフトアセンブリ(230、330)に掛かる長手方向に配向された力に応じてのみハンドルアセンブリ(220、320)から除去されることを確保することが望ましいであろう。
トランスデューサアセンブリ(12)の一部の変更形態において、導波管(102)のねじ付き穴(104)への改良された自己案内を提供するように構成されたが望ましいであろう。図21は、そのような自己案内スタッド(500)の実施例を示す。スタッド(500)の第1の部分(502)は、ねじ切り部(505)を含む。スタッド(500)の第1の部分(502)は、トランスデューサアセンブリ(12)のホーン(12D)の遠位部分へ螺入される。第2の部分(504)は、ホーン(12D)の遠位端から遠位に延在する。第2の部分(504)は、ねじ切り部(506)を含む。ねじ切り部(505)は、有効外径(D1)を画定する。ねじ切り部(506)は、有効外径(D2)を画定する。直径(D1)は、直径(D2)よりも大きい。第2の部分(504)のねじ切り部(506)は、スタッド(500)の外部周りの螺旋状の経路に沿って、遷移領域(507)において第1の部分(502)のねじ切り部(505)へ徐々に遷移する。この遷移領域(507)の螺旋状の経路は、ほぼ360°経路、ほぼ720°、又は、任意の他の好適な角度範囲に沿って延在し得る。遷移領域(507)について角度範囲を増大させると、遷移が緩やかになることを理解されたい。
器具(10)の一部の変更形態において、適切な量のトルクがトランスデューサアセンブリ(12)に確実な導波管(102)に適用されたときにユーザに信号を送る特徴部を提供することが望ましいであろう。図22〜図24は、ユーザフィードバック装置(602)と通信するそのような処理特徴部(600)の実施例を示す。この実施例において、トルクレンチ(610)は、導波管(102)をトランスデューサアセンブリ(12)に手作業で固定するために使用される。トルクレンチ(610)は、エンドエフェクタ(40)上に位置決めされると図示されているが、トルクレンチは、その代わりに、シャフトアセンブリ(30)の一部及び/又は器具(10)の一部の他の特徴部と係合(例えば、シャフトアセンブリ(30)などの近位端に向かって下方に摺動)し得ることを理解されたい。本実施例のトルクレンチ(610)は、導波管(102)をトランスデューサアセンブリ(12)に固定するためにトルクレンチ(610)が適切な量のトルクを印加したときに可聴クリック音を発するように構成される。あくまでも一例として、トルクレンチ(610)は、その開示が、本明細書において、参照することにより組み込まれる、2007年8月16日公開の米国特許出願公開第2007/0191713号、発明の名称「Ultrasonic Device for Cutting and Coagulating」の教示の少なくとも一部にしたがって構築され、かつ、動作可能であり得る。
明細書に記載される器具のいずれの変形も、本明細書で上述されるものに加えて、又はそれらの代わりに、様々な他の特徴部を含んでもよいことを理解されたい。一例にすぎないが、本明細書で説明されたいずれの器械も、参照により本明細書に組み込まれる種々の参考文献のいずれかで開示された、種々の特徴部のうちの1つ又は2つ以上を含むことができる。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得るため、本明細書の教示は、本明細書の他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が理解されよう。本明細書の教示が組み込まれ得る他の種類の器具が、当業者には明らかであろう。
(1) 組織を手術する装置であって、
(a)本体アセンブリと、
(b)電力を超音波振動に変換するように動作可能である超音波トランスデューサと、
(c)前記本体アセンブリから遠位に延在するシャフトアセンブリであって、超音波振動を送信するように動作可能な導波管を含む、シャフトアセンブリと、
(d)前記超音波トランスデューサを回転させ、それによって前記超音波トランスデューサを前記導波管と選択的に結合するように作動可能なモータと、
(e)前記本体アセンブリに対する前記シャフトアセンブリの少なくとも一部の回転を選択的に防止するように構成されたロック特徴部と、
を備える、装置。
(2) 前記ロック特徴部は、ロック部材を延在させ、それによって前記本体アセンブリに対する前記シャフトアセンブリの少なくとも一部の回転を防止するように構成されたソレノイドを含む、実施態様1に記載の装置。
(3) 前記本体アセンブリは、センサを含み、前記センサは、前記本体アセンブリに対する前記シャフトアセンブリの長手方向の位置決めを感知するように構成されている、実施態様1に記載の装置。
(4) 前記センサは、磁石を含む、実施態様3に記載の装置。
(5) 前記センサは、前記本体アセンブリに対する前記シャフトアセンブリの近位の移動に応じて前記ロック特徴部を起動させるように構成されている、実施態様3に記載の装置。
(7) 前記シャフトアセンブリは、長手方向に並進可能な部材を含む、実施態様1に記載の装置。
(8) 前記並進可能な部材は、近位の長手方向の位置と遠位の長手方向の位置との間で移動可能である、実施態様7に記載の装置。
(9) 前記モータは、前記並進可能な部材が前記近位の長手方向の位置と前記遠位の長手方向の位置との間で移動されるときに前記超音波トランスデューサを回転させるように構成されている、実施態様8に記載の装置。
(10) 前記並進可能な部材は、前記シャフトアセンブリの内面に係合するように構成された複数の弾性アームを含む、実施態様7に記載の装置。
(12) 前記シャフトアセンブリは、1対の環状凹部を画定する内面を含む、実施態様11に記載の装置。
(13) 前記少なくとも1つのタブは、前記1対の環状凹部に係合するように構成されている、実施態様12に記載の装置。
(14) 前記1対の環状凹部は、前記並進可能な部材の並進を制限するように構成されている、実施態様13に記載の装置。
(15) 前記装置は、前記シャフトアセンブリ内で側方に配向された力を感知するように構成された応力感知特徴部を更に備える、実施態様1に記載の装置。
(17) 前記シャフトアセンブリは、ねじ付きスタッドによって前記超音波トランスデューサに接続され、前記ねじ付きスタッドは、第1のねじ部及び第2のねじ部を含み、前記第1のねじ部は、第1の有効外径を画定し、前記第2のねじ部は、第2の有効外径を画定し、前記第1の有効外径は、前記第2の有効外径を上回る、実施態様1に記載の装置。
(18) 導波管を超音波トランスデューサに装着する方法であって、
(a)前記導波管を前記超音波トランスデューサに接続するステップであって、前記導波管を前記超音波トランスデューサに接続する前記行為は、前記超音波トランスデューサ内に少なくとも1つの振動パルスを作り出し、超音波トランスデューサは、前記振動パルスに応じて少なくとも1つの対応する電圧パルスを生成する、ステップと、
(b)前記超音波トランスデューサによって生成された前記少なくとも1つの対応する電圧パルスを感知するステップと、
(c)前記少なくとも1つの対応する電圧パルスの特性を分析するステップと、
(d)前記少なくとも1つの対応する電圧パルスの前記分析された特性に基づいて、適切な接続が前記導波管と前記超音波トランスデューサとの間でなされたかどうかを示すフィードバックをオペレータに提供するステップと、
を含む、方法。
(19) 前記少なくとも1つの対応する電圧パルスの特性を分析する行為は、少なくとも第1の電圧パルス及び第2の電圧パルスの振幅を判定することを含む、実施態様18に記載の方法。
(20) シャフトアセンブリを外科用器具の本体アセンブリに装着する方法であって、前記シャフトアセンブリは、超音波導波管及び長手方向に並進可能な部材を含み、前記本体アセンブリは、超音波トランスデューサと、センサと、ロック部材と、モータとを含み、前記本体アセンブリは、ソケットを含み、前記方法は、
(a)前記シャフトアセンブリを前記本体アセンブリの前記ソケット内に位置決めするステップと、
(b)前記ソケット内の前記シャフトアセンブリを感知するステップと、
(c)前記並進可能な部材を遠位の長手方向の位置から近位の長手方向の位置に並進させるステップと、
(c)前記ロック部材を1回目に作動させるステップであって、前記ロック部材を1回目に作動させる前記行為は、前記本体アセンブリに対する前記シャフトアセンブリの回転を防止する、ステップと、
(d)前記モータを作動させるステップであって、前記モータを作動させる前記行為は、前記超音波トランスデューサを前記超音波導波管に固定する、ステップと、
(e)前記ロック部材を2回目に作動させるステップであって、前記ロック部材を2回目に作動させる前記行為は、前記本体アセンブリに対する前記シャフトアセンブリの回転を可能にする、ステップと、
を含む、方法。
Claims (20)
- 組織を手術する装置であって、
(a)本体アセンブリと、
(b)電力を超音波振動に変換するように動作可能である超音波トランスデューサと、
(c)前記本体アセンブリから遠位に延在するシャフトアセンブリであって、超音波振動を送信するように動作可能な導波管を含む、シャフトアセンブリと、
(d)前記超音波トランスデューサを回転させ、それによって前記超音波トランスデューサを前記導波管と選択的に結合するように作動可能なモータと、
(e)前記本体アセンブリに対する前記シャフトアセンブリの少なくとも一部の回転を選択的に防止するように構成されたロック特徴部と、
を備える、装置。 - 前記ロック特徴部は、ロック部材を延在させ、それによって前記本体アセンブリに対する前記シャフトアセンブリの少なくとも一部の回転を防止するように構成されたソレノイドを含む、請求項1に記載の装置。
- 前記本体アセンブリは、センサを含み、前記センサは、前記本体アセンブリに対する前記シャフトアセンブリの長手方向の位置決めを感知するように構成されている、請求項1に記載の装置。
- 前記センサは、磁石を含む、請求項3に記載の装置。
- 前記センサは、前記本体アセンブリに対する前記シャフトアセンブリの近位の移動に応じて前記ロック特徴部を起動させるように構成されている、請求項3に記載の装置。
- 前記センサは、前記本体アセンブリに対する前記シャフトアセンブリの遠位の移動に応じて前記ロック特徴部を停止させるように構成されている、請求項3に記載の装置。
- 前記シャフトアセンブリは、長手方向に並進可能な部材を含む、請求項1に記載の装置。
- 前記並進可能な部材は、近位の長手方向の位置と遠位の長手方向の位置との間で移動可能である、請求項7に記載の装置。
- 前記モータは、前記並進可能な部材が前記近位の長手方向の位置と前記遠位の長手方向の位置との間で移動されるときに前記超音波トランスデューサを回転させるように構成されている、請求項8に記載の装置。
- 前記並進可能な部材は、前記シャフトアセンブリの内面に係合するように構成された複数の弾性アームを含む、請求項7に記載の装置。
- 前記並進可能な部材は、前記シャフトアセンブリの内面に係合するように構成された少なくとも1つのタブを含む、請求項7に記載の装置。
- 前記シャフトアセンブリは、1対の環状凹部を画定する内面を含む、請求項11に記載の装置。
- 前記少なくとも1つのタブは、前記1対の環状凹部に係合するように構成されている、請求項12に記載の装置。
- 前記1対の環状凹部は、前記並進可能な部材の並進を制限するように構成されている、請求項13に記載の装置。
- 前記装置は、前記シャフトアセンブリ内で側方に配向された力を感知するように構成された応力感知特徴部を更に備える、請求項1に記載の装置。
- 前記応力感知特徴部は、前記シャフトアセンブリ内の非長手方向の力を感知することに応じて、前記シャフトアセンブリが前記本体アセンブリから取り外されるのを防止するように構成されている、請求項15に記載の装置。
- 前記シャフトアセンブリは、ねじ付きスタッドによって前記超音波トランスデューサに接続され、前記ねじ付きスタッドは、第1のねじ部及び第2のねじ部を含み、前記第1のねじ部は、第1の有効外径を画定し、前記第2のねじ部は、第2の有効外径を画定し、前記第1の有効外径は、前記第2の有効外径を上回る、請求項1に記載の装置。
- 導波管を超音波トランスデューサに装着する方法であって、
(a)前記導波管を前記超音波トランスデューサに接続するステップであって、前記導波管を前記超音波トランスデューサに接続する前記行為は、前記超音波トランスデューサ内に少なくとも1つの振動パルスを作り出し、超音波トランスデューサは、前記振動パルスに応じて少なくとも1つの対応する電圧パルスを生成する、ステップと、
(b)前記超音波トランスデューサによって生成された前記少なくとも1つの対応する電圧パルスを感知するステップと、
(c)前記少なくとも1つの対応する電圧パルスの特性を分析するステップと、
(d)前記少なくとも1つの対応する電圧パルスの前記分析された特性に基づいて、適切な接続が前記導波管と前記超音波トランスデューサとの間でなされたかどうかを示すフィードバックをオペレータに提供するステップと、
を含む、方法。 - 前記少なくとも1つの対応する電圧パルスの特性を分析する行為は、少なくとも第1の電圧パルス及び第2の電圧パルスの振幅を判定することを含む、請求項18に記載の方法。
- シャフトアセンブリを外科用器具の本体アセンブリに装着する方法であって、前記シャフトアセンブリは、超音波導波管及び長手方向に並進可能な部材を含み、前記本体アセンブリは、超音波トランスデューサと、センサと、ロック部材と、モータとを含み、前記本体アセンブリは、ソケットを含み、前記方法は、
(a)前記シャフトアセンブリを前記本体アセンブリの前記ソケット内に位置決めするステップと、
(b)前記ソケット内の前記シャフトアセンブリを感知するステップと、
(c)前記並進可能な部材を遠位の長手方向の位置から近位の長手方向の位置に並進させるステップと、
(c)前記ロック部材を1回目に作動させるステップであって、前記ロック部材を1回目に作動させる前記行為は、前記本体アセンブリに対する前記シャフトアセンブリの回転を防止する、ステップと、
(d)前記モータを作動させるステップであって、前記モータを作動させる前記行為は、前記超音波トランスデューサを前記超音波導波管に固定する、ステップと、
(e)前記ロック部材を2回目に作動させるステップであって、前記ロック部材を2回目に作動させる前記行為は、前記本体アセンブリに対する前記シャフトアセンブリの回転を可能にする、ステップと、
を含む、方法。
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WO2015077138A2 (en) | 2015-05-28 |
EP3071126B1 (en) | 2018-01-10 |
US20190328419A1 (en) | 2019-10-31 |
US20150148830A1 (en) | 2015-05-28 |
JP6518665B2 (ja) | 2019-05-22 |
BR112016011571A2 (pt) | 2017-08-08 |
CN105744904A (zh) | 2016-07-06 |
MX2016006639A (es) | 2017-01-16 |
WO2015077138A3 (en) | 2015-08-06 |
CN105744904B (zh) | 2019-08-09 |
US10368892B2 (en) | 2019-08-06 |
EP3071126A2 (en) | 2016-09-28 |
US11589887B2 (en) | 2023-02-28 |
BR112016011571B1 (pt) | 2022-01-11 |
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