JP2020044364A - 多機能手術用アクセスシステム - Google Patents
多機能手術用アクセスシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3423—Access ports, e.g. toroid shape introducers for instruments or hands
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0293—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with ring member to support retractor elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3462—Trocars; Puncturing needles with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
- A61B17/3496—Protecting sleeves or inner probes; Retractable tips
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
- A61B17/3421—Cannulas
- A61B17/3431—Cannulas being collapsible, e.g. made of thin flexible material
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3494—Trocars; Puncturing needles with safety means for protection against accidental cutting or pricking, e.g. limiting insertion depth, pressure sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00982—General structural features
- A61B2017/00991—Telescopic means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
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- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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- Veterinary Medicine (AREA)
- Pathology (AREA)
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- Materials For Medical Uses (AREA)
Abstract
Description
本願は、全体として、医療用デバイスに関し、更に詳細には、開創器を含む手術用アクセスシステムに関する。
本明細書中に開示した実施例と同様の手術用アクセスシステムが、米国特許公開第2005/0241647A1号、米国特許公開第2007/0185387A1号、米国特許公開第2007/0149859A1号、及び米国特許公開第2007/0088202A1号に開示されている。出典を明示することにより、これらの特許公開に開示された全ての内容は本明細書の開示の一部とされる。
ポリエステル編製布及び布の一方の面に積層した50μm(2ミル)のポリウレタン層を含むポリウレタン積層布(PUL−2ミル シーブライト)についての耐穿刺性をFED−STD−101/2065に従って計測した。試験では、3.175mm(0.125インチ)の円形のシャフトを7.6cm×7.6cm(3インチ×3インチ)の布サンプルと毎分7.6cm(毎分3インチ)で接触する。試験を、円形のシャフトを布のポリエステル面と接触させて15個のサンプルについて行い、61.07N(13.73ポンド)の平均耐穿刺性を得た。ポリウレタン側について行った15回の試験の平均耐穿刺性は、53.56N(12.04ポンド)であった。
本開創器シースで使用した76μm(4ミル)のポリエーテルポリウレタンフィルム(ペレタン(ペレタン(PELLETHANE)は登録商標である)2363、ルブリゾール)の耐穿刺性を上文中に説明したのと同様に計測した。15回の試験についての平均値は12.46N(2.80ポンド)であった。
幾つかの実施例では、布は、手術器具によって不時に刺されたり切られたりすることにより、又は以下に説明するようにシース150を意図的に穿刺することにより損傷を受けた場合、裂け目が拡がるのに抵抗する。このような布の例には、裂け止め布即ちリップストップ布、特定の編み生地、及び編みメッシュ生地が含まれる。幾つかの実施例では、布の配向により、シースに器具を通すときに器具を妨げる欠陥が生じる可能性を減少する。例えば、幾つかの実施例では、布の滑らかな表面がシースの長さ方向軸線に面し、即ちシースの内側に面する。幾つかの実施例では、布は斜行配置されているか或いは、縁がシースの長さ方向軸線とほぼ平行である。適当な布は、リップストップポリアミド(ナイロン(ナイロン(NYLON)は登録商標である)、オックスフォード織りの布、耐磨耗性ポリエステル及び/又はポリアミド布(コンジュラ(コンジュラ(Condura)は登録商標である)、編みモノフィラメント布、等である。
上述の内リングの幾つかの実施例では、シャフトは本体内に選択的に係止できる。これは、例えばラチェット及び爪を使用して、開口部及び/又は内腔/チャンネルを潰すことによって、ロックナットによって、ロックリングによって、摩擦によって、又はその他の方法によって行われる。図14に示す実施例では、内リング1430の平面図はほぼ円形である。他の実施例では、内リングは、上文中に説明した別の形状を有する。他の実施例は、複数の本体及びシャフトを含む。幾つかの実施例では、本体は二つの端部を持つ本体であり、即ち本体の各端は、シャフトを入れ子式に受け入れる寸法を備えている。シャフトもまた二つの端部を持つシャフトであり、即ちシャフトの各端を本体に挿入できる。外リングの幾つかの実施例は調節を同様に行うことができる。
102 近位端
104 遠位端
106 機器アクセスチャンネル
110 外アンカー即ち近位アンカー
130 内アンカー即ち遠位アンカー
150 可撓性シース
Claims (22)
- 組織開創器において、
近位端から遠位端まで延びる器具アクセスチャンネルを形成する長さ方向軸線と、
外リングと、
内リングと、
前記外アンカーと前記内アンカーとの間を延びるチューブ状可撓性シースとを含み、
前記器具アクセスチャンネルは、前記外リング、前記内リング、及び前記シースを通って延び、
前記シースの少なくとも一部が耐穿刺性である、組織開創器。 - 請求項1に記載の組織開創器において、
前記外リングは環状軸線を有し、この環状軸線を中心として前記外リングを回転できる、組織開創器。 - 請求項2に記載の組織開創器において、
前記外リングは、長軸及び短軸を含む断面を有し、
前記長軸は、前記長さ方向軸線とほぼ平行であり、
前記外リングは、周囲内腔及びこの内腔内に配置されたフープを含む、組織開創器。 - 請求項1に記載の組織開創器において、
前記外リングは複数のフックを含み、これらのフックに前記シースを係合できる、組織開創器。 - 請求項1に記載の組織開創器において、
前記外リングは、近位リング及び遠位リングを含み、
前記近位リングは前記遠位リングと入れ子になっており、
前記近位リング及び前記遠位リングの入れ子表面は、遠位方向で先細になっており、
前記シースは、前記近位リングと前記遠位リングとの間に配置できる、組織開創器。 - 請求項1に記載の組織開創器において、
前記内リングは再成形可能である、組織開創器。 - 請求項1に記載の組織開創器において、
前記内リング及び前記外リングの少なくとも一方は、円形又は楕円形である、組織開創器。 - 請求項1に記載の組織開創器において、
前記内リング及び前記外リングの一方は、前記内リング及び前記外リングの他方よりも大径である、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースのほぼ全体が耐穿刺性である、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分のFED−STD−101/2065に従って計測した耐穿刺性は、少なくとも約16N(3.6ポンド(1.633kg))である、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、長さ方向軸線に沿って実質的に非伸長性である、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、周方向に膨張可能である、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、布、織布、不織布、及び編製布のうちの少なくとも一つを含む、組織開創器。 - 請求項13に記載の組織開創器において、
布、織布、不織布、及び編製布のうちの少なくとも一つの少なくとも一方の面にポリマー層が配置されている、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、繊維強化ポリマーメンブレンを含む、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、少なくとも一つの長さ方向スリットを含む、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、複数の長さ方向バンドを含み、
隣接した長さ方向バンドの縁部が重なっている、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、複数の層を含む、組織開創器。 - 請求項1に記載の組織開創器において、
前記シースの前記耐穿刺性部分は、天然ポリマー、半合成ポリマー、半合成ポリマー、合成ポリマー、金属、セラミック、ガラス、カーボンファイバ、カーボンナノチューブ、セルロース、絹、ニトロセルロース、セルロースアセテート、レーヨン、ポリエステル、芳香族ポリエステル、ポリアミド、アラミド、ポリイミド、ポリオレフィン、ポリエチレン、ポリウレタン、ポリウレア、ポリ塩化ビニル(PVC)、塩化ポリビニリデン、ポリエーテルアミド、ポリエーテルウレタン、ポリアクリレート、ポリアクリロニトリル、アクリル樹脂、ポリフェニレンスルフィド(PPS)、ポリ乳酸(PLA)、ポリ(ジイミダゾピリジニレン−ジヒドロキシフェニレン)(M−5)、ポリ(p−フェニレン−2,6−ベンゾビスオキザゾール)、液晶ポリマーファイバ、ステンレス鋼、ばね鋼、ニチノール、超弾性材料、アモルファス金属合金、等のうちの少なくとも一つを含む複数のファイバを含む、組織開創器。 - 請求項1に記載の組織開創器において、更に、
近位フランジ及び前記フランジの開口部から遠位方向に延びるチューブ状部分を含むシールドを含み、前記チューブ状部分は、アクセスチャンネルに挿入されるように寸法が定められている、組織開創器。 - 組織開創器において、
近位端から遠位端まで延びる器具アクセスチャンネルを形成する長さ方向軸線と、
外リングと、
内リングと、
前記外アンカーと前記内アンカーとの間を延びるチューブ状可撓性シースとを含み、
前記器具アクセスチャンネルは、前記外リング、前記内リング、及び前記シースを通って延び、
前記シースの少なくとも一部のFED−STD−101/2065に従って計測した耐穿刺性は、少なくとも約16N(3.6ポンド(1.633kg))である、組織開創器。 - 組織開創器において、
近位端から遠位端まで延びる器具アクセスチャンネルを形成する長さ方向軸線と、
外リングと、
内リングと、
前記外アンカーと前記内アンカーとの間を延びるチューブ状可撓性シースとを含み、
前記器具アクセスチャンネルは、前記外リング、前記内リング、及び前記シースを通って延び、
前記シースの少なくとも一部は耐穿刺性であり、長さ方向で非伸長性である、組織開創器。
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Families Citing this family (89)
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EP2343031B1 (en) | 2002-06-05 | 2013-08-07 | Applied Medical Resources Corporation | Wound retractor |
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AR070764A1 (es) * | 2007-12-07 | 2010-05-05 | Pyng Medical Corp | Aparatos y metodos para introducir portales oseos |
USD738500S1 (en) | 2008-10-02 | 2015-09-08 | Covidien Lp | Seal anchor for use in surgical procedures |
US20100298646A1 (en) * | 2009-05-19 | 2010-11-25 | Tyco Healthcare Group Lp | Flexible access assembly with reinforced lumen |
ES2623399T3 (es) | 2009-09-22 | 2017-07-11 | Doheny Eye Institute | Sistemas y dispositivos de cánula ajustable |
US9017252B2 (en) | 2010-04-12 | 2015-04-28 | Covidien Lp | Access assembly with flexible cannulas |
CN103002793B (zh) * | 2010-05-13 | 2015-07-22 | Livac私人有限公司 | 抽吸式牵开器 |
US9022926B2 (en) * | 2010-11-23 | 2015-05-05 | Covidien Lp | Reinforced flexible access assembly |
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US8641610B2 (en) | 2010-12-20 | 2014-02-04 | Covidien Lp | Access assembly with translating lumens |
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US9078696B2 (en) * | 2011-05-02 | 2015-07-14 | Covidien Lp | Surgical retractor including polygonal rolling structure |
US9161807B2 (en) | 2011-05-23 | 2015-10-20 | Covidien Lp | Apparatus for performing an electrosurgical procedure |
US9521996B2 (en) | 2011-07-13 | 2016-12-20 | Cook Medical Technologies Llc | Surgical retractor device |
US20130066158A1 (en) * | 2011-08-05 | 2013-03-14 | Carlos Rodriguez | Fabric Retraction Device and Method for Minimally Invasive Surgery |
CA2797624A1 (en) * | 2011-12-07 | 2013-06-07 | Covidien Lp | Thoracic access assembly |
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CA2771337A1 (en) | 2011-03-03 |
JP6629904B2 (ja) | 2020-01-15 |
JP6247003B2 (ja) | 2017-12-13 |
AU2010286353A1 (en) | 2012-03-01 |
JP2018114322A (ja) | 2018-07-26 |
WO2011026124A1 (en) | 2011-03-03 |
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US20170319234A1 (en) | 2017-11-09 |
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CA2771337C (en) | 2018-05-01 |
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