JP2018526093A - 組織成長を促進する補助材料 - Google Patents
組織成長を促進する補助材料 Download PDFInfo
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- JP2018526093A JP2018526093A JP2018510999A JP2018510999A JP2018526093A JP 2018526093 A JP2018526093 A JP 2018526093A JP 2018510999 A JP2018510999 A JP 2018510999A JP 2018510999 A JP2018510999 A JP 2018510999A JP 2018526093 A JP2018526093 A JP 2018526093A
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Abstract
Description
様々な手術用器具が、本明細書で開示された補助材及び/又は薬剤と共に使用され得る。「補助材」は、本明細書において、「補助材料」とも呼ばれる。手術用器具は、手術用ステープラを含み得る。様々な手術用ステープラ、例えば、線状手術用ステープラ及び輪状ステープラが使用され得る。概して、線状ステープラが、長手方向ステープルラインを形成するように構成されることができ、細長いジョーを含むことができる。このジョーは、それに連結され、長手方向ステープル列を収容しているカートリッジを有する。細長いジョーは、ジョー内に保持された組織に沿って、ステープル列間の切断を形成することができるナイフ又は他の切断部材を含み得る。概して、輪状ステープラは、環状ステープルラインを形成するように構成されることができ、輪状ジョーを含むことができる。この輪状ジョーは、環状ステープル列を収容しているカートリッジを有する。輪状ジョーは、ジョー内に保持された組織を通る開口を画定するためのステープル列の内側の切断を形成することができるナイフ又は他の切断部材を含み得る。ステープラは、様々な異なる外科的処置において、例えば、胸部手術又は胃部手術において、様々な組織での様々な異なる外科的処置に使用され得る。
上記されたように、様々な植え込み可能な補助材が、手術用ステープル留め器具と共に使用するのに提供される。補助材は、様々な構成を有することができ、様々な材料から形成されることができる。一般的に、補助材は、1つ以上のフィルム、発泡体、射出成形熱可塑性材料、真空熱成形材料、繊維性構造体、及びそれらのハイブリッドから形成され得る。また、補助材は、1つ以上の生物由来材料及び1つ以上の薬物も含み得る。これらの材料はそれぞれ、以下により詳細に検討される。
記載された技術に基づく補助材は、様々な材料から形成され得る。材料は、異なる目的での様々な実施形態に使用され得る。材料は、組織内方成長を促進するために、組織に提供されるべき所望の治療に従って選択され得る。以下に記載された材料は、任意の所望の組み合わせで、補助材を形成するのに使用され得る。
記載された技術に基づく補助材は、例えば、組織内方成長に対して、所望の様式で所望の効果を提供するために、多くの異なる方法で、少なくとも1種の薬剤と関連付けられ得る。少なくとも1種の薬剤は、施療部位において、所望の治癒プロセスをトリガするために、複数の空間的及び時間的パターンにおいて、補助材から放出されるように構成され得る。薬剤は、補助材内に配置され、補助材に結合し、補助材内に組み込まれ、補助材内に分散され、又は補助材と他の方法で関連付けられ得る。例えば、補助材は、内部に、1種以上の異なる薬剤を放出可能に保持している、1つ以上の領域を有し得る。この領域は、様々なサイズ及び形状の、様々な方法で内部に薬剤を保持する、別個のリザーバであるか、又は、補助材内の他の別個の、若しくは連続した領域であることができる。いくつかの態様では、補助材の特定の構成により、1種の薬剤又は2種以上の異なる薬剤を、内部に放出可能に保持することができる。
外科的処置の実行中に、患者の組織は、様々な様式のいずれかにおいて、傷つく場合がある(例えば、切除、引き裂き、穿刺など)。創傷は、例えば、吻合術において、及び/又は、組織が切断され、手術用装置、例えば、手術用ステープラを使用してファスナ留めされる場合、外科的処置の意図した態様である場合がある。傷ついた組織は、典型的には、全ての患者について一般的に同じ様式で経時的に治癒する。
組織成長を促進するための、種々の例示的な補助材料は、本明細書で記載されている。概して、植え込み可能な補助材は、ステープルと併用する手術用ステープラにより組織に適用されるように構成され得る。補助材は、所定の様式で組織内方成長に対する所望の効果を提供するのに有効な、その内部に放出可能に保持された1種以上の薬剤を有することができる。補助材に関連する1つ以上の特徴は、例えば、組織成長を特定の方向に亢進させることにより、並びに/又は、特定の領域及び/若しくは特定の構造における組織成長を抑制することにより、創傷治癒中での所望の様式における秩序的組織再形成を促進するための種々の実施間で変更され得る。補助材に関連する特徴は、補助材の構造(例えば、補助材を形成するファイバの間隔(例えば、ファイバの密度)、補助材を形成するファイバの配向、補助材を形成するファイバの太さ又は直径、補助材を形成するファイバの材料、補助材を形成するファイバの弾性、及び補助材を形成するファイバの電荷)、1種以上の薬剤が補助材内に配置される位置(例えば、補助材の特定の側上及び補助材の特定の領域内)、及び、1種以上の薬剤の機能(例えば、組織内方成長における薬剤の所望の効果、薬剤の溶出速度、薬剤の投与量、及び薬剤の種類)を含む。特定の補助材の特徴に応じて、補助材が、秩序的組織再形成を促進するように構成されることができ、1種以上の薬剤が、秩序的組織再形成を促進するように構成されることができ、又は、補助材及び1種以上の薬剤の両方が、秩序的組織再形成を促進するように構成されることができる。
(1) 手術用ステープラと共に使用するためのステープルカートリッジアセンブリであって、
複数のステープル空洞を有するカートリッジ本体であって、各ステープル空洞は、内部に配置された手術用ステープルを有する、カートリッジ本体と、
前記カートリッジ本体に解放可能に保持され、前記カートリッジ本体内の前記ステープルを配備することによって、組織に運搬されるように構成されている生体適合性補助材料であって、前記補助材料は、ファイバ格子の形態にあり、前記ファイバ格子は、少なくとも2つの別個の異質なファイバ格子区画を有し、前記補助材料の前記ファイバ格子区画はそれぞれ、所望の様式での秩序的組織再形成を促進するように構成されたパターンで配置されている、生体適合性補助材料と、
前記補助材料内に配置され、前記補助材料から放出可能な、有効量の少なくとも1種の薬剤であって、前記少なくとも1種の薬剤はそれぞれ、所定の様式で組織内方成長に所望の効果を提供するのに有効であり、前記少なくとも1種の薬剤はそれぞれ、均質な様式で前記補助材料から放出可能である、有効量の少なくとも1種の薬剤と、を備える、ステープルカートリッジアセンブリ。
(2) 前記補助材料は、生体吸収性及び溶解性のいずれかを有する、複数のファイバから構成されている、実施態様1に記載のアセンブリ。
(3) 前記少なくとも1種の薬剤は、前記ファイバの吸収又は溶解の際に溶出する、実施態様2に記載のアセンブリ。
(4) 前記ファイバ格子区画は、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、実施態様1に記載のアセンブリ。
(5) 前記少なくとも2つの別個の異質なファイバ格子区画は、3つのファイバ格子区画を含み、前記3つのファイバ格子区画はそれぞれ、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、実施態様1に記載のアセンブリ。
(7) 手術用器具用のエンドエフェクタであって、
着脱可能に取り付けられたカートリッジ本体を有する第1のジョーであって、前記カートリッジ本体は、内部にステープルを設置するように構成されている複数のステープル空洞を、組織に面する表面に有する、第1のジョーと、
組織に面する表面上に形成された複数のステープル成形空洞を有するアンビルを有する第2のジョーであって、前記第1のジョー及び前記第2のジョーの少なくとも一方は、他方に対して移動可能である、第2のジョーと、
前記第1のジョー及び第2のジョーの前記組織に面する表面の少なくとも一方上に解放可能に保持され、前記カートリッジ本体内の前記ステープルを配備することによって、組織に運搬されるように構成されている生体適合性補助材料であって、前記補助材料は、少なくとも2つの別個の異質なファイバ格子区画を有する、ファイバ格子の形態にあり、前記補助材料の前記ファイバ格子区画はそれぞれ、所望の様式での秩序的組織再形成を促進するように構成されたパターンで配置されている、生体適合性補助材料と、
前記補助材料内に配置され、前記補助材料から放出可能な、有効量の少なくとも1種の薬剤であって、前記少なくとも1種の薬剤はそれぞれ、所定の様式で組織内方成長に所望の効果を提供するのに有効であり、前記少なくとも1種の薬剤はそれぞれ、均質な様式で前記補助材料から放出可能である、有効量の少なくとも1種の薬剤と、を備える、エンドエフェクタ。
(8) 前記補助材料は、生体吸収性及び溶解性のいずれかを有する、複数のファイバから構成されている、実施態様7に記載のエンドエフェクタ。
(9) 前記少なくとも1種の薬剤は、前記ファイバの吸収又は溶解の際に溶出する、実施態様8に記載のエンドエフェクタ。
(10) 前記ファイバ格子区画は、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、実施態様7に記載のエンドエフェクタ。
(12) 前記少なくとも1種の薬剤は、抗菌剤、抗真菌剤、抗ウイルス剤、抗炎症剤、成長因子、鎮痛薬、抗ガン剤、抗接着剤、組織マトリックス分解阻害剤、栄養、酸素排除剤、アミノ酸、コラーゲン合成剤、グルタミン、インスリン、ブチレート、及びデキストランのうちの少なくとも1つを含む、実施態様7に記載のエンドエフェクタ。
Claims (12)
- 手術用ステープラと共に使用するためのステープルカートリッジアセンブリであって、
複数のステープル空洞を有するカートリッジ本体であって、各ステープル空洞は、内部に配置された手術用ステープルを有する、カートリッジ本体と、
前記カートリッジ本体に解放可能に保持され、前記カートリッジ本体内の前記ステープルを配備することによって、組織に運搬されるように構成されている生体適合性補助材料であって、前記補助材料は、ファイバ格子の形態にあり、前記ファイバ格子は、少なくとも2つの別個の異質なファイバ格子区画を有し、前記補助材料の前記ファイバ格子区画はそれぞれ、所望の様式での秩序的組織再形成を促進するように構成されたパターンで配置されている、生体適合性補助材料と、
前記補助材料内に配置され、前記補助材料から放出可能な、有効量の少なくとも1種の薬剤であって、前記少なくとも1種の薬剤はそれぞれ、所定の様式で組織内方成長に所望の効果を提供するのに有効であり、前記少なくとも1種の薬剤はそれぞれ、均質な様式で前記補助材料から放出可能である、有効量の少なくとも1種の薬剤と、を備える、ステープルカートリッジアセンブリ。 - 前記補助材料は、生体吸収性及び溶解性のいずれかを有する、複数のファイバから構成されている、請求項1に記載のアセンブリ。
- 前記少なくとも1種の薬剤は、前記ファイバの吸収又は溶解の際に溶出する、請求項2に記載のアセンブリ。
- 前記ファイバ格子区画は、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、請求項1に記載のアセンブリ。
- 前記少なくとも2つの別個の異質なファイバ格子区画は、3つのファイバ格子区画を含み、前記3つのファイバ格子区画はそれぞれ、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、請求項1に記載のアセンブリ。
- 前記少なくとも1種の薬剤は、抗菌剤、抗真菌剤、抗ウイルス剤、抗炎症剤、成長因子、鎮痛薬、抗ガン剤、抗接着剤、組織マトリックス分解阻害剤、栄養、酸素排除剤、アミノ酸、コラーゲン合成剤、グルタミン、インスリン、ブチレート、及びデキストランのうちの少なくとも1つを含む、請求項1に記載のアセンブリ。
- 手術用器具用のエンドエフェクタであって、
着脱可能に取り付けられたカートリッジ本体を有する第1のジョーであって、前記カートリッジ本体は、内部にステープルを設置するように構成されている複数のステープル空洞を、組織に面する表面に有する、第1のジョーと、
組織に面する表面上に形成された複数のステープル成形空洞を有するアンビルを有する第2のジョーであって、前記第1のジョー及び前記第2のジョーの少なくとも一方は、他方に対して移動可能である、第2のジョーと、
前記第1のジョー及び第2のジョーの前記組織に面する表面の少なくとも一方上に解放可能に保持され、前記カートリッジ本体内の前記ステープルを配備することによって、組織に運搬されるように構成されている生体適合性補助材料であって、前記補助材料は、少なくとも2つの別個の異質なファイバ格子区画を有する、ファイバ格子の形態にあり、前記補助材料の前記ファイバ格子区画はそれぞれ、所望の様式での秩序的組織再形成を促進するように構成されたパターンで配置されている、生体適合性補助材料と、
前記補助材料内に配置され、前記補助材料から放出可能な、有効量の少なくとも1種の薬剤であって、前記少なくとも1種の薬剤はそれぞれ、所定の様式で組織内方成長に所望の効果を提供するのに有効であり、前記少なくとも1種の薬剤はそれぞれ、均質な様式で前記補助材料から放出可能である、有効量の少なくとも1種の薬剤と、を備える、エンドエフェクタ。 - 前記補助材料は、生体吸収性及び溶解性のいずれかを有する、複数のファイバから構成されている、請求項7に記載のエンドエフェクタ。
- 前記少なくとも1種の薬剤は、前記ファイバの吸収又は溶解の際に溶出する、請求項8に記載のエンドエフェクタ。
- 前記ファイバ格子区画は、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、請求項7に記載のエンドエフェクタ。
- 前記少なくとも2つの別個の異質なファイバ格子区画は、3つのファイバ格子区画を含み、前記3つのファイバ格子区画はそれぞれ、第1の方向におけるファイバ密度、第2の方向におけるファイバ密度、ファイバ材料、ファイバ構造、ファイバ径、ファイバの表面特性、ファイバ電荷、及びファイバ弾性のうちの少なくとも1つにおいて互いに異なる、請求項7に記載のエンドエフェクタ。
- 前記少なくとも1種の薬剤は、抗菌剤、抗真菌剤、抗ウイルス剤、抗炎症剤、成長因子、鎮痛薬、抗ガン剤、抗接着剤、組織マトリックス分解阻害剤、栄養、酸素排除剤、アミノ酸、コラーゲン合成剤、グルタミン、インスリン、ブチレート、及びデキストランのうちの少なくとも1つを含む、請求項7に記載のエンドエフェクタ。
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US10130738B2 (en) | 2018-11-20 |
JP6797900B2 (ja) | 2020-12-09 |
EP3135317B1 (en) | 2021-11-03 |
EP3135317A1 (en) | 2017-03-01 |
BR112018003874A2 (pt) | 2018-09-25 |
BR112018003874B1 (pt) | 2021-08-10 |
CN108348649B (zh) | 2021-07-02 |
CN108348649A (zh) | 2018-07-31 |
US20170056566A1 (en) | 2017-03-02 |
WO2017040108A1 (en) | 2017-03-09 |
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