JP2017530840A - 電動医療用デバイスのための複数のモータ制御 - Google Patents
電動医療用デバイスのための複数のモータ制御 Download PDFInfo
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- JP2017530840A JP2017530840A JP2017531974A JP2017531974A JP2017530840A JP 2017530840 A JP2017530840 A JP 2017530840A JP 2017531974 A JP2017531974 A JP 2017531974A JP 2017531974 A JP2017531974 A JP 2017531974A JP 2017530840 A JP2017530840 A JP 2017530840A
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- sensor
- end effector
- motor
- surgical instrument
- anvil
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Abstract
Description
本出願は、それぞれ本出願と同時出願された、出願整理番号END7420USNP/140125、名称「CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE」、END7421USNP/140126、名称「ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION」、END7422USNP/140127、名称「MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION」、END7423USNP/140128、名称「MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR’S OUTPUT OR INTERPRETATION」、END7424USNP/140129、名称「POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRIDGE」、END7425USNP/140130、名称「SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION」、及び END7427USNP/140132、名称「LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION」に関し、それらそれぞれの全体を参照により本明細書に組み込む。
本発明の実施形態は、外科用器具に関し、様々な状況において、組織をステープル留めし切断するように設計された、外科用ステープル留め及び切断器具並びにそのステープルカートリッジに関する。
図28は、第1のセンサ3008a及び第2のセンサ3008bを備えるエンドエフェクタ3000の一実施形態を示している。エンドエフェクタ3000は、上述したエンドエフェクタ300に類似している。エンドエフェクタ3000は、第2の顎部材3004に枢動可能に結合された、第1の顎部材、即ちアンビル3002を備える。第2の顎部材3004は、ステープルカートリッジ3006を中に受け入れるように構成されている。ステープルカートリッジ3006は、複数のステープル(図示せず)を備える。複数のステープルは、外科的動作の間、ステープルカートリッジ3006から配備可能である。エンドエフェクタ3000は、第1のセンサ3008aを備える。第1のセンサ3008aは、エンドエフェクタ3000の1つ又は2つ以上のパラメータを測定するように構成されている。例えば、一実施形態では、第1のセンサ3008aは、アンビル3002と第2の顎部材3004との間のギャップ3010を測定するように構成されている。第1のセンサ3008aは、例えば、第2の顎部材3004及び/又はステープルカートリッジ3006に埋め込まれた磁石3012によって生成される磁界を検出するように構成された、ホール効果センサを備えてもよい。別の例として、一実施形態では、第1のセンサ3008aは、第2の顎部材3004によって、かつ/又はアンビル3002と第2の顎部材3004との間に掴持された組織によって、アンビル3002に対して及ぼされる1つ又は2つ以上の力を測定するように構成されている。
図52は、掴持動作中の組織部分の1つ又は2つ以上のパラメータを判断するように構成されたエンドエフェクタ3600の一実施形態を示している。エンドエフェクタ3600は、第2の顎部材3604に枢動可能に結合された、第1の顎部材、即ちアンビル3602を備える。第2の顎部材3604は、ステープルカートリッジ3606を中に受け入れるように構成されている。ステープルカートリッジ3606は、掴持及びステープル留め動作の間に組織部分内に配備されるように構成された、複数のステープル(図示せず)を収容している。ステープルカートリッジ3606は、既定の高さを有するステープルカートリッジデッキ3622を備える。ステープルカートリッジ3606は、上述のスロット193に類似した、ステープルカートリッジの本体内に画定されたスロット3624を更に備える。ホール効果センサ3608は、ホール効果センサ3608と第2の顎部材3604に結合された磁石3610との間の距離3616を検出するように構成されている。ホール効果センサ3608と磁石3610との間の距離3616は、アンビル3602とステープルカートリッジデッキ3622との間に配置された組織の厚さを示す。
図74は、外科用器具10のエンドエフェクタ300の部分図を示している。図74に示される例示の形態では、エンドエフェクタ300は、多くの点でステープルカートリッジ304(図20)に類似しているステープルカートリッジ1100を備える。エンドエフェクタ300のいくつかの部品は、本開示をより明瞭に理解できるように省略されている。特定の例では、エンドエフェクタ300は、例えばアンビル306(図20)などの第1の顎と、例えばチャネル198(図20)などの第2の顎とを含んでもよい。特定の例では、上述したように、チャネル198は、例えばステープルカートリッジ304又はステープルカートリッジ1100など、ステープルカートリッジを収容してもよい。ステープルカートリッジ1100とアンビル306との間で組織を捕捉するため、チャネル198及びアンビル306の少なくとも一方は、チャネル198及びアンビル306の他方に対して移動可能であってもよい。チャネル198及び/又はアンビル306の、例えば開放構成(図1)と閉鎖構成(図75)との間での運動を容易にする、様々な作動組立体が本明細書に記載されている。
図91〜93は、例えば外科用器具4400などの外科用器具と接続された、複数のモータを備える共通制御モジュールを用いる装置、システム、及び方法の様々な実施形態を示している。外科用器具4400は、例えば、より詳細に上述した図1の外科用器具10など、本開示によって記載される他の外科用器具に、多くの点で類似している。例えば、図91に示されるように、外科用器具4400は、ハウジング12と、ハンドル14と、閉鎖トリガ32と、シャフト組立体200と、外科用エンドエフェクタ300とを含む。したがって、開示を簡潔かつ明瞭にするため、外科用器具10と共通している、外科用器具4400の特定の特性についての詳細な説明は、ここでは繰り返さない。
図95A及び1Bは、2つの発光ダイオード(LED)5310を更に備えるステープルカートリッジ5306を備える、エンドエフェクタ5300の一実施形態を示している。エンドエフェクタ5300は、上述したエンドエフェクタ300に類似している。エンドエフェクタは、第2の顎部材又は細長いチャネル5304に枢動可能に結合された、第1の顎部材又はアンビル5302を備える。細長いチャネル5304は、ステープルカートリッジ5306を中に受け入れるように構成されている。ステープルカートリッジ5306は、複数のステープル(図示せず)を備える。外科的動作の間、複数のステープルがステープルカートリッジ5306から配備可能である。ステープルカートリッジ5306は、ステープルカートリッジ5306の上面、又はカートリッジデッキ5308上に装着される、2つのLED 5310を更に備える。LED 5310は、アンビル5304が閉位置にあるときに目に見えるように装着される。更に、LED 5310は、LED 5310の直視を妨げることがある組織を通して見えるように、十分に明るいものであることができる。それに加えて、少なくとも1つのLED 5310がエンドエフェクタ5300のどちらかの側から見えるように、1つのLED 5310をステープルカートリッジ5306どちらかの側に装着することができる。LED 5310は、例示されるように、ステープルカートリッジ530の近位端付近に装着することができ、又はステープルカートリッジ5306の遠位端に装着されてもよい。
図98Aは、導電性素子5512の層を更に備える組織コンペンセータ5510を備える、エンドエフェクタ5500の一実施形態を示している。エンドエフェクタ5500は、上述したエンドエフェクタ300に類似している。エンドエフェクタ5500は、第2の顎部材5504(図示せず)に動可能に結合された、第1の顎部材、即ちアンビル5502を備える。第2の顎部材5504は、ステープルカートリッジ5506を中に受け入れるように構成されている(図示せず)。ステープルカートリッジ5506は、複数のステープル(図示せず)を備える。外科的動作の間、複数のステープル191がステープルカートリッジ3006から配備可能である。いくつかの実施形態では、エンドエフェクタ5500は、アンビル5502上又はステープルカートリッジ5506上に取り外し可能に位置付けられる、組織コンペンセータ5510を更に備える。図98Bは、図98Aに示される組織コンペンセータ5510の一部分の詳細図を示している。
図108は、ステープルカートリッジ6006を識別するのに検出磁界6016を使用することができる、磁石6008及びホール効果センサ6010を備えるエンドエフェクタ6000の一実施形態を示している。エンドエフェクタ6000は、上述したエンドエフェクタ300に類似している。エンドエフェクタ6000は、第2の顎部材又は細長いチャネル6004に枢動可能に結合された、第1の顎部材又はアンビル6002を備える。細長いチャネル6004は、ステープルカートリッジ6006を中で動作可能に支持するように構成されている。ステープルカートリッジ6006は、上述したステープルカートリッジ304に類似している。アンビル6002は、磁石6008を更に備える。ステープルカートリッジ6006は、ホール効果センサ6010及びプロセッサ6012を更に備える。ホール効果センサ6010は、導電結合6014を通してプロセッサ6012と連通するように動作可能である。ホール効果センサ6010は、アンビル6002が閉位置にあるとき、磁石6008と動作可能に結合するように、ステープルカートリッジ6006内で位置付けられる。ホール効果センサ6010は、磁石6008によって作り出される磁界6016を検出するように動作可能であることができる。磁界6016の極性は、アンビル6002内における磁石6008の配向に応じて、北又は南の一方であることができる。図108の例示される実施形態では、磁石6008は、その南極がステープルカートリッジ6006に向かって方向付けられるように配向される。ホール効果センサ6010は、南極によって作り出される磁界6016を検出するように動作可能であることができる。ホール効果センサ6010が南磁極を検出した場合、ステープルカートリッジ6006を第1のタイプのものと識別することができる。
一実施形態では、本明細書に記載する外科用器具は、センサ及び/又は電子構成要素に対する短絡保護技術を備える。かかるセンサ及び他の電子技術を使用可能にするため、電力及びデータ信号の両方が、外科用器具のモジュール式構成要素間で転送される。モジュール式センサ構成要素の組立の間、接続されると、接続された構成要素間で電力及びデータ信号を転送するのに使用される電気導体は、一般的に露出している。
図126A及び126Bは、プロセッサ10012と連通している磁石10008及びホール効果センサ10010を備えるエンドエフェクタ10000の一実施形態を示している。エンドエフェクタ10000は、上述したエンドエフェクタ300に類似している。エンドエフェクタは、第2の顎部材、又は細長いチャネル10004に枢動可能に結合された、第1の顎部材、即ちアンビル10002を備える。細長いチャネル10004は、ステープルカートリッジ10006を中で動作可能に支持するように構成されている。ステープルカートリッジ10006は、上述したステープルカートリッジ304に類似している。アンビル10008は、磁石10008を備える。ステープルカートリッジは、ホール効果センサ10010及びプロセッサ10012を備える。ホール効果センサ10010は、導電結合10014を通してプロセッサ10012と連通するように動作可能である。ホール効果センサ10010は、アンビル10002が閉位置にあるとき、磁石10008と動作可能に結合するように、ステープルカートリッジ10006内で位置付けられる。ホール効果センサ10010は、磁石10008の移動又は位置による、ホール効果センサ10010を取り囲む磁界の変化を検出するように構成することができる。
(1) 外科用器具であって、
エンドエフェクタであって、
第1の顎と、
第2の顎と、を備え、前記第1の顎及び前記第2の顎のうちの少なくとも一方が、開放構成と近接構成との間で、前記第1の顎及び前記第2の顎のうちの他方に対して移動可能である、エンドエフェクタと、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータ及び前記第2のモータに動作可能に結合可能である制御モジュールと、
閉鎖トリガと、を備え、前記閉鎖トリガが、閉鎖工程の間に前記エンドエフェクタを前記近接構成に遷移させるように移動可能であり、前記閉鎖トリガが、前記閉鎖工程の間に前記制御モジュールを、前記第1のモータとの動作可能な係合から前記第2のモータとの動作可能な係合へと遷移させるように移動可能である、外科用器具。
(2) 前記制御モジュールがモータドライバを含む、実施態様1に記載の外科用器具。
(3) 前記モータドライバは、前記エンドエフェクタが前記開放構成にある間、前記第1のモータに電気的に結合され、前記モータドライバは、前記エンドエフェクタが前記近接構成にある間、前記第2のモータに電気的に結合されている、実施態様2に記載の外科用器具。
(4) 前記制御モジュールがスイッチを含み、前記スイッチが第1の位置と第2の位置との間で移動可能であり、前記スイッチが、前記第1の位置で、前記モータドライバを前記第1のモータに電気的に結合し、前記スイッチが、前記第2の位置で、前記モータドライバを前記第2のモータに電気的に結合する、実施態様2に記載の外科用器具。
(5) 前記閉鎖トリガは、前記閉鎖トリガの移動が、前記スイッチを、前記第1の位置と前記第2の位置との間で遷移させるように、前記スイッチと動作可能に結合されている、実施態様4に記載の外科用器具。
(7) 前記第1の駆動組立体が、前記エンドエフェクタを関節運動させるように動作可能である関節駆動組立体を含む、実施態様1に記載の外科用器具。
(8) 前記第2の駆動組立体が、発射駆動組立体を含む、実施態様1に記載の外科用器具。
(9) 前記制御モジュールが電源を含む、実施態様1に記載の外科用器具。
(10) 外科用器具であって、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータとの連携と前記第2のモータとの連携との間で選択的に切り替え可能である制御モジュールと、を備える、外科用器具。
(12) 前記第2の駆動組立体が、発射駆動組立体を含む、実施態様10に記載の外科用器具。
(13) 前記制御モジュールが電源を含む、実施態様10に記載の外科用器具。
(14) 前記制御モジュールが、モータドライバを含む、実施態様10に記載の外科用器具。
(15) 前記制御モジュールがスイッチを含む、実施態様14に記載の外科用器具。
(17) 外科用器具であって、
エンドエフェクタと、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータ及び前記第2のモータに動作可能に結合可能である制御モジュールと、
前記エンドエフェクタを有効にするのと同時に、前記制御モジュールを、前記第1のモータとの動作可能な係合から、前記第2のモータとの動作可能な係合に遷移させるように移動可能であるトリガと、を備える、外科用器具。
(18) 前記第1の駆動組立体が前記エンドエフェクタを関節運動させるように動作可能である関節駆動組立体を含む、実施態様17に記載の外科用器具。
(19) 前記エンドエフェクタがステープルカートリッジを備え、前記ステープルカートリッジが、前記エンドエフェクタによって捕捉された組織内に配備可能である複数のステープルを含み、前記第2の駆動組立体が前記複数のステープルを配備するように動作可能である発射駆動組立体を含む、実施態様17に記載の外科用器具。
(20) 前記制御モジュールが電源を含む、実施態様17に記載の外科用器具。
Claims (20)
- 外科用器具であって、
エンドエフェクタであって、
第1の顎と、
第2の顎と、を備え、前記第1の顎及び前記第2の顎のうちの少なくとも一方が、開放構成と近接構成との間で、前記第1の顎及び前記第2の顎のうちの他方に対して移動可能である、エンドエフェクタと、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータ及び前記第2のモータに動作可能に結合可能である制御モジュールと、
閉鎖トリガと、を備え、前記閉鎖トリガが、閉鎖工程の間に前記エンドエフェクタを前記近接構成に遷移させるように移動可能であり、前記閉鎖トリガが、前記閉鎖工程の間に前記制御モジュールを、前記第1のモータとの動作可能な係合から前記第2のモータとの動作可能な係合へと遷移させるように移動可能である、外科用器具。 - 前記制御モジュールがモータドライバを含む、請求項1に記載の外科用器具。
- 前記モータドライバは、前記エンドエフェクタが前記開放構成にある間、前記第1のモータに電気的に結合され、前記モータドライバは、前記エンドエフェクタが前記近接構成にある間、前記第2のモータに電気的に結合されている、請求項2に記載の外科用器具。
- 前記制御モジュールがスイッチを含み、前記スイッチが第1の位置と第2の位置との間で移動可能であり、前記スイッチが、前記第1の位置で、前記モータドライバを前記第1のモータに電気的に結合し、前記スイッチが、前記第2の位置で、前記モータドライバを前記第2のモータに電気的に結合する、請求項2に記載の外科用器具。
- 前記閉鎖トリガは、前記閉鎖トリガの移動が、前記スイッチを、前記第1の位置と前記第2の位置との間で遷移させるように、前記スイッチと動作可能に結合されている、請求項4に記載の外科用器具。
- 前記閉鎖トリガが、前記閉鎖工程の間、前記エンドエフェクタを前記近接構成に遷移させるのと同時に、前記制御モジュールを、前記第1のモータとの前記動作可能な係合から、前記第2のモータとの前記動作可能な係合に遷移させるように移動可能である、請求項1に記載の外科用器具。
- 前記第1の駆動組立体が、前記エンドエフェクタを関節運動させるように動作可能である関節駆動組立体を含む、請求項1に記載の外科用器具。
- 前記第2の駆動組立体が、発射駆動組立体を含む、請求項1に記載の外科用器具。
- 前記制御モジュールが電源を含む、請求項1に記載の外科用器具。
- 外科用器具であって、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータとの連携と前記第2のモータとの連携との間で選択的に切り替え可能である制御モジュールと、を備える、外科用器具。 - 前記第1の駆動組立体が、前記エンドエフェクタを関節運動させるように動作可能である関節駆動組立体を含む、請求項10に記載の外科用器具。
- 前記第2の駆動組立体が、発射駆動組立体を含む、請求項10に記載の外科用器具。
- 前記制御モジュールが電源を含む、請求項10に記載の外科用器具。
- 前記制御モジュールが、モータドライバを含む、請求項10に記載の外科用器具。
- 前記制御モジュールがスイッチを含む、請求項14に記載の外科用器具。
- 前記スイッチが第1の位置と第2の位置との間で移動可能であり、前記スイッチが、前記第1の位置で、前記モータドライバを前記第1のモータに電気的に結合し、前記スイッチが、前記第2の位置で、前記モータドライバを前記第2のモータに電気的に結合する、請求項15に記載の外科用器具。
- 外科用器具であって、
エンドエフェクタと、
第1の駆動組立体と、
前記第1の駆動組立体に結合された第1のモータであって、前記第1の駆動組立体を動機付けるように動作可能である、第1のモータと、
第2の駆動組立体と、
前記第2の駆動組立体に結合された第2のモータであって、前記第2の駆動組立体を動機付けるように動作可能である、第2のモータと、
前記第1のモータ及び前記第2のモータに動作可能に結合可能である制御モジュールと、
前記エンドエフェクタを有効にするのと同時に、前記制御モジュールを、前記第1のモータとの動作可能な係合から、前記第2のモータとの動作可能な係合に遷移させるように移動可能であるトリガと、を備える、外科用器具。 - 前記第1の駆動組立体が前記エンドエフェクタを関節運動させるように動作可能である関節駆動組立体を含む、請求項17に記載の外科用器具。
- 前記エンドエフェクタがステープルカートリッジを備え、前記ステープルカートリッジが、前記エンドエフェクタによって捕捉された組織内に配備可能である複数のステープルを含み、前記第2の駆動組立体が前記複数のステープルを配備するように動作可能である発射駆動組立体を含む、請求項17に記載の外科用器具。
- 前記制御モジュールが電源を含む、請求項17に記載の外科用器具。
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