JP2017520360A - 電気外科的密封・切開システム - Google Patents
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Abstract
Description
本願は、2014年5月30日に出願された米国特許仮出願第62/005,009号及び2014年5月30日に出願された米国特許仮出願第62/004,980号の権益主張出願であり、これらの米国特許仮出願を参照により引用し、これらの開示内容全体を本明細書の一部とする。
Claims (82)
- 電気外科的器械であって、
第1のジョーを有し、
第1のジョーと向かい合った第2のジョーを有し、前記第1のジョー及び前記第2のジョーは、前記第1のジョーと前記第2のジョーとの間に組織を把持するよう回動可能に配置され、
前記第1のジョーに連結された電極を有し、
前記第2のジョーに連結された電極を有し、前記第1及び前記第2のジョーの前記電極は、互いに向かい合った前記第1のジョーの中央部分と前記第2のジョーの中央部分に電極がない状態で、高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間の組織を溶融させて切断するよう配置されている、電気外科的器械。 - 前記第1のジョーは、前記第1のジョーの前記中央部分に設けられたランディングパッドを有する、請求項1記載の電気外科的器械。
- 前記ランディングパッドは、圧縮性であり、前記ランディングパッドは、前記ジョーが前記ジョー相互間に組織を把持して溶融させるときに圧縮される、請求項1又は2記載の電気外科的器械。
- 前記ランディングパッドは、シリコーンで作られている、請求項1〜3のうちいずれか一に記載の電気外科的器械。
- 前記第1のジョーの前記電極に隣接して位置する前記第1のジョーの所々に設けられている前記ランディングパッドの所々は、前記第2のジョーの前記電極と接触関係にある、請求項1〜4のうちいずれか一に記載の電気外科的器械。
- 前記ランディングパッドは、前記第1のジョーの全長にわたって延びている、請求項1〜5のうちいずれか一に記載の電気外科的器械。
- 前記第1の電極は、組織に接触する第1の表面積を備え、前記第2の電極は、組織に接触する第2の表面積を備え、前記第1の表面積は、前記第2の表面積に等しく、
前記第2のジョーは、組織に接触する第3の表面積を備えた第3の電極及び組織に接触する第4の表面積を備えた第4の電極を有し、前記第3の表面積は、前記第4の表面積に等しく、前記第4の表面積は、前記第1の表面積よりも大きく、
前記第1の電極及び前記第3の電極は、長手方向軸線の一方の側で高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させるよう配置され、前記第2の電極及び前記第4の電極は、長手方向軸線の反対側で高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させるよう配置されている、請求項1〜6のうちいずれか一に記載の電気外科的器械。 - 前記第2のジョーは、前記第1のジョーから遠ざかる方向に向いた表面上に設けられている第5の電極を有する、請求項1〜7のうちいずれか一に記載の電気外科的器械。
- 前記第5の電極は、前記第1の表面積よりも小さい表面積を備えている、請求項1〜8のうちいずれか一に記載の電気外科的器械。
- 前記ランディングパッドは、前記第5の電極並びに前記第3及び前記第4の電極の所々の真上に配置されている、請求項1〜9のうちいずれか一に記載の電気外科的器械。
- 前記第2のジョーは、前記第2のジョー内に完全に納められたスロットを更に有し、該スロットは、近位側の閉鎖終端部及び遠位側の閉鎖終端部を有する、請求項1〜10のうちいずれか一に記載の電気外科的器械。
- 前記ランディングパッドは、前記スロットの真上に配置されている、請求項1〜11のうちいずれか一に記載の電気外科的器械。
- 前記スロットは、前記第5の電極の前記表面積に等しい表面積を備えている、請求項1〜12のうちいずれか一に記載の電気外科的器械。
- 前記スロットは、前記ランディングパッドの表面領域よりも狭い表面領域を画定している、請求項1〜13のうちいずれか一に記載の電気外科的器械。
- 前記第3の電極及び前記第4の電極は、前記電極相互間で伝わる高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間に位置する組織を切断するよう配置されている、請求項1〜14のうちいずれか一に記載の電気外科的器械。
- 前記第5の電極は、組織が前記ジョー相互間に把持されていない間についてのみ、前記第5の電極と前記第4の電極との間で伝わる高周波エネルギーを用いて前記第2のジョーの外側に位置する組織を切断するよう配置されている、請求項1〜15のうちいずれか一に記載の電気外科的器械。
- 前記第1の電極及び前記第4の電極は、互いに同一の極性を有するよう配置され、前記第2の電極及び前記第3の電極は、前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させるよう、互いに等しく且つ前記第1及び前記第4の電極の前記極性とは異なる極性を有するよう配置されている、請求項1〜16のうちいずれか一に記載の電気外科的器械。
- 組織を溶融させて切断するよう前記電気外科的器械を介して高周波(RF)エネルギーを供給するよう構成された電気外科的発生器と組み合わせて用いられる請求項1〜17のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、
組織を溶融させて切断するよう構成された前記電気外科的器械を介してRFエネルギーを供給するRF増幅器と、
供給された前記RFエネルギーの位相角を定期的にモニタするよう構成された制御装置とを有し、前記制御装置は、前記モニタされた位相角がゼロよりも大きくしかも増大している場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧を増大させる、請求項1〜18のうちいずれか一に記載の電気外科的器械。 - 前記制御装置は、前記モニタされた位相角が減少している場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項1〜19のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、供給された前記RFエネルギーの前記位相角の変化率を定期的にモニタする、請求項1〜20のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記位相角の前記変化率が所定のしきい率を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項1〜21のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記モニタされた位相角が引き続き所定のしきい角を超えている場合、引き続き信号を前記RF増幅器に送って前記RFエネルギーの電圧を増大させる、請求項1〜22のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、電圧を所定の一定の割合で増大させる、請求項1〜23のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°である、請求項1〜24のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°〜15°である、請求項1〜25のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記RF増幅器がRFエネルギーを供給し続けている間に前記モニタされた位相角が所定のしきい角を超えた場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧増加を停止させる、請求項1〜26のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、15°未満である、請求項1〜27のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、前記RFエネルギーの電圧を増大させながら前記ジョー相互間の温度を100℃未満に維持する、請求項1〜28のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、前記ジョー相互間の温度が100℃を超えた場合、供給される前記RFエネルギーを停止させる、請求項1〜29のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、供給された前記RFエネルギーの電圧及び電流を測定し、測定された前記電圧及び前記電流から位相角をモニタする、請求項1〜30のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、前記モニタされた位相角が40°未満である場合、前記RFエネルギーを供給し続ける、請求項1〜31のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記位相角が所定のしきい値を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項1〜32のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°である、請求項1〜33のうちいずれか一に記載の電気外科的器械。
- 電気外科的器械であって、
組織に接触する第1の表面積を備えた第1の電極及び組織に接触する第2の表面積を備えた第2の電極を有する第1のジョーを含み、前記第1の表面積は、前記第2の表面積に等しく、
前記第1のジョーと対向して位置した状態で前記第1のジョーとの間に組織を把持するよう前記第1のジョーに結合された第2のジョーを含み、前記第2のジョーは、組織に接触する第3の表面積を備えた第3の電極及び組織に接触する第4の表面積を備えた第4の電極を有し、前記第3の表面積は、前記第4の表面積に等しく、前記第4の表面積は、前記第1の表面積よりも大きく、
前記第1の電極と前記第3の電極は、長手方向軸線の一方の側で高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させるよう配置され、前記第2の電極と前記第4の電極は、長手方向軸線の反対側で高周波エネルギーを用いて第1のジョーと第2のジョーとの間に位置する組織を溶融させるよう配置されている、電気外科的器械。 - 前記第2のジョーは、前記第1のジョーから遠ざかる方向に向いた表面上に設けられている第5の電極を有する、請求項35記載の電気外科的器械。
- 前記第5の電極は、前記第1の表面積よりも小さい表面積を備えている、請求項35又は36記載の電気外科的器械。
- 前記第1のジョーは、前記第5の電極並びに前記第3の電極及び前記第4の電極のところどころの真上に配置されたランディングパッドを更に有する、請求項35〜37のうちいずれか一に記載の電気外科的器械。
- 前記第2のジョーは、前記第2のジョー内に完全に納められたスロットを更に有し、該スロットは、近位側の閉鎖終端部及び遠位側の閉鎖終端部を有する、請求項35〜38のうちいずれか一に記載の電気外科的器械。
- 前記ランディングパッドは、前記スロットの真上に配置されている、請求項35〜39のうちいずれか一に記載の電気外科的器械。
- 前記スロットは、前記第5の電極の前記表面積に等しい表面積を備えている、請求項35〜40のうちいずれか一に記載の電気外科的器械。
- 前記スロットは、前記ランディングパッドの表面領域よりも狭い表面領域を画定している、請求項35〜41のうちいずれか一に記載の電気外科的器械。
- 前記第3の電極及び前記第4の電極は、前記電極相互間で伝わる高周波エネルギーを用いて前記第1のジョーと前記第2のジョーとの間に位置する組織を切断するよう配置されている、請求項35〜42のうちいずれか一に記載の電気外科的器械。
- 前記第5の電極は、組織が前記ジョー相互間に把持されていない間についてのみ、前記第5の電極と前記第4の電極との間で伝わる高周波エネルギーを用いて前記第2のジョーの外側に位置する組織を切断するよう配置されている、請求項35〜43のうちいずれか一に記載の電気外科的器械。
- 前記第1の電極及び前記第4の電極は、互いに同一の極性を有するよう配置され、前記第2の電極及び前記第3の電極は、前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させるよう、互いに同一であり且つ前記第1及び前記第4の電極の前記極性とは異なる極性を有するよう配置されている、請求項35〜44のうちいずれか一に記載の電気外科的器械。
- 組織を溶融させて切断するよう前記電気外科的器械を介して高周波(RF)エネルギーを供給するよう構成された電気外科的発生器と組み合わせて用いられる請求項35〜45のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、
組織を溶融させて切断するよう構成された前記電気外科的器械を介してRFエネルギーを供給するRF増幅器と、
供給された前記RFエネルギーの位相角をモニタするよう構成された制御装置とを有し、前記制御装置は、前記モニタされた位相角がゼロよりも大きくしかも増大している場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧を増大させる、請求項35〜46のうちいずれか一に記載の電気外科的器械。 - 前記制御装置は、前記モニタされた位相角が減少している場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項35〜47のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、供給された前記RFエネルギーの前記位相角の変化率を定期的にモニタする、請求項35〜48のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記位相角の前記変化率が所定のしきい率を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項35〜49のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記モニタされた位相角が引き続き所定のしきい角を超えている場合、引き続き信号を前記RF増幅器に送って前記RFエネルギーの電圧を増大させる、請求項35〜50のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、電圧を所定の一定の割合で増大させる、請求項35〜51のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°である、請求項35〜52のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°〜15°である、請求項35〜53のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記RF増幅器がRFエネルギーを供給し続けている間に前記モニタされた位相角が所定のしきい角を超えた場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧増加を停止させる、請求項35〜54のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、15°未満である、請求項35〜55のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、前記RFエネルギーの電圧を増大させながら前記ジョー相互間の温度を100℃未満に維持する、請求項35〜56のうちいずれか一に記載の電気外科的器械。
- 前記RF増幅器は、前記ジョー相互間の温度が100℃を超えた場合、供給される前記RFエネルギーを停止させる、請求項35〜57のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、供給された前記RFエネルギーの電圧及び電流を測定し、測定された前記電圧及び前記電流から位相角をモニタする、請求項35〜58のうちいずれか一に記載の電気外科的器械。
- 前記発生器は、前記モニタされた位相角が40°未満である場合、前記RFエネルギーを供給し続ける、請求項35〜59のうちいずれか一に記載の電気外科的器械。
- 前記制御装置は、前記位相角が所定のしきい値を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項35〜60のうちいずれか一に記載の電気外科的器械。
- 前記所定のしきい角は、5°である、請求項35〜61のうちいずれか一に記載の電気外科的器械。
- 高周波(RF)エネルギーを供給して組織を溶融させて切断するよう構成された電気外科的発生器であって、前記発生器は、
RFエネルギーだけで組織を溶融させて切断するよう構成された取り外し可能に結合されている電気外科的溶融及び切開用器を介してRFエネルギーを供給するRF増幅器と、
供給された前記RFエネルギーの位相角をモニタするよう構成された制御装置とを有し、前記制御装置は、モニタされた前記位相角がゼロよりも大きく且つ増大している場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧を増大させる、電気外科的発生器。 - 前記制御装置は、モニタされた前記位相角が減少している場合、信号をRF増幅器に送って供給される前記RFエネルギーを停止させる、請求項63記載の電気外科的発生器。
- 前記制御装置は、供給された前記RFエネルギーの前記位相角の変化率を定期的にモニタする、請求項63又は64記載の電気外科的発生器。
- 前記制御装置は、前記位相角の前記変化率が所定のしきい率を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項63〜65のうちいずれか一に記載の電気外科的発生器。
- 前記制御装置は、前記モニタされた位相角が引き続き所定のしきい角を超えている場合、引き続き信号を前記RF増幅器に送って前記RFエネルギーの電圧を増大させる、請求項63〜66のうちいずれか一に記載の電気外科的発生器。
- 前記RF増幅器は、電圧を所定の一定の割合で増大させる、請求項63〜67のうちいずれか一に記載の電気外科的発生器。
- 前記所定のしきい角は、5°である、請求項63〜68のうちいずれか一に記載の電気外科的発生器。
- 前記所定のしきい角は、5°〜15°である、請求項63〜69のうちいずれか一に記載の電気外科的発生器。
- 前記制御装置は、前記RF増幅器がRFエネルギーを供給し続けている間に前記モニタされた位相角が所定のしきい角を超えた場合、信号を前記RF増幅器に送って供給される前記RFエネルギーの電圧増加を停止させる、請求項63〜70のうちいずれか一に記載の電気外科的発生器。
- 前記所定のしきい角は、15°未満である、請求項63〜71のうちいずれか一に記載の電気外科的発生器。
- 前記RF増幅器は、前記RFエネルギーの電圧を増大させながら前記ジョー相互間の温度を100℃未満に維持する、請求項63〜72のうちいずれか一に記載の電気外科的発生器。
- 前記RF増幅器は、前記ジョー相互間の温度が100℃を超えた場合、供給される前記RFエネルギーを停止させる、請求項63〜73のうちいずれか一に記載の電気外科的発生器。
- 前記発生器は、供給された前記RFエネルギーの電圧及び電流を測定し、測定された前記電圧及び前記電流から位相角をモニタする、請求項63〜74のうちいずれか一に記載の電気外科的発生器。
- 前記発生器は、前記モニタされた位相角が40°未満である場合、前記RFエネルギーを供給し続ける、請求項63〜75のうちいずれか一に記載の電気外科的発生器。
- 前記制御装置は、前記位相角が所定のしきい値を下回った場合、信号を前記RF増幅器に送って供給される前記RFエネルギーを停止させる、請求項63〜76のうちいずれか一に記載の電気外科的発生器。
- 前記所定のしきい角は、5°である、請求項63〜77のうちいずれか一に記載の電気外科的発生器。
- 前記電気外科的溶融及び切開用器は、細長いシャフトと、前記細長いシャフトの遠位端部のところに設けられた1対のジョーと、前記細長いシャフトの近位端部のところに設けられていて前記ジョーを開閉して前記ジョー相互間に位置する組織を切断するよう構成されたアクチュエータとを有する、請求項63〜78のうちいずれか一に記載の電気外科的発生器。
- 前記電気外科的溶融及び切開用器は、第1のジョーに設けられた1対の電極及び第2のジョーに設けられていて且つ前記第1のジョーと前記第2のジョーとの間にRFエネルギーを伝えて前記第1のジョーと前記第2のジョーとの間に位置する組織を溶融させて切断するよう構成された1対の電極を有する、請求項63〜79のうちいずれか一に記載の電気外科的発生器。
- 前記電気外科的溶融及び切開用器は、第1のジョーに設けられた1対の電極及び第2のジョーに設けられた1対の電極を有し、前記第2のジョーに設けられた前記1対の電極は、前記第1のジョーと前記第2のジョーに設けられた前記電極対相互間にのみRFエネルギーを伝えて前記第1のジョーと前記第2のジョーとの間に位置する組織の溶融と切断の両方を行うよう構成されている、請求項63〜80のうちいずれか一に記載の電気外科的発生器。
- 前記電気外科的溶融及び切開用器は、第1のジョーに設けられた1対の電極及び第2のジョーに設けられた1対の電極を有し、前記第2のジョーに設けられた前記1対の電極は、前記第1のジョーと前記第2のジョーに設けられた前記電極対相互間にのみRFエネルギーを伝えて前記第1のジョーと前記第2のジョーとの間に位置する組織を最初に溶融させ、次に切断するよう構成されている、請求項63〜81のうちいずれか一に記載の電気外科的発生器。
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EP3148465B1 (en) | 2018-05-16 |
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US10792092B2 (en) | 2020-10-06 |
CA2949242A1 (en) | 2015-12-03 |
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EP4368134A2 (en) | 2024-05-15 |
ES2682950T3 (es) | 2018-09-24 |
US20200397501A1 (en) | 2020-12-24 |
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AU2015266619A1 (en) | 2016-11-17 |
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