JP2020512038A - 電気外科用器具 - Google Patents
電気外科用器具 Download PDFInfo
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Abstract
Description
マイクロ波EMエネルギーおよびRFEMエネルギーは、器具シャフトを通る共通信号経路に沿って伝えられ得る。例えば、同軸伝送線路により、マイクロ波EMエネルギーおよびRFEMエネルギーの両方を伝えるための共通信号経路を提供することができる。この構成では、遠位端組立品は、切開器要素からのマイクロ波EMエネルギーを遮断するための誘導性フィルタと、1対のジョーにあるエネルギー送達構造からのRFEMエネルギーを遮断するための容量性フィルタとを備えることがある。もう1つの構成では、RFEMエネルギーおよびマイクロ波EMエネルギーは、器具シャフト内の別々の経路に沿って伝えられ、誘導性フィルタおよび容量性フィルタが、例えばハンドル内の、器具シャフトの近位端に設けられる。
本発明は、マイクロ波エネルギーを送達して、血管を封止することができる電気外科用脈管封止具デバイスに関する。このデバイスは、直視下手術で使用することができるが、治療部位へのアクセスが制限される処置での特別の用途を見出すことができる。例えば、本発明の電気外科用脈管封止具は、外科用スコープデバイス(すなわち、腹腔鏡、内視鏡など)の器具チャネル内に嵌合するように適合させることができる。図1は、本発明の電気外科用脈管封止具が使用され得る電気外科用装置100の概略図を示す。
(文献1)Presthus, et al.: Vessel sealing using a pulsed bipolar system and open forceps, J Am Assoc Gynecol Laparosc 10(4):528−533, 2003.
(文献2)Carbonell, et al.: A comparison of laparoscopic bipolar vessel sealing devices in the hemostasis of small−, medium−, and large−sized arteries, J Laparoendosc Adv Surg Tech 13(6):377−380, 2003
(文献3)Richter, et al.: Efficacy and quality of vessel sealing, Surg Endosc (2006) 20: 890−894
Claims (27)
- マイクロ波電磁(EM)エネルギーを伝えるための同軸伝送線路を備える器具シャフトと、
前記器具シャフトから前記マイクロ波EMエネルギーを受け取るように前記器具シャフトの遠位端に構成された遠位端組立品であって、
1対のジョーであって、その対向する内面の間の間隙を開閉するために互いと相対的に移動できる前記1対のジョーと、
生体組織を切り開くためのブレードと
を備えた、前記遠位端組立品と
を備える電気外科用脈管封止具であって、
前記1対のジョーが、前記対向する内面の間の前記間隙に前記マイクロ波EMエネルギーを放射するように構成されたエネルギー送達構造を備え、
前記エネルギー送達構造が、前記1対のジョーの一方または両方の前記内面に取り付けられた共平面マイクロストリップアンテナを備え、前記共平面マイクロストリップアンテナが、放射されたマイクロ波場を実質的に前記1対のジョー間の領域の内側に閉じ込めるように構成され、
前記ブレードが、前記1対のジョー間の前記領域を通って移動できるように、前記遠位端組立品の内部に摺動自在に配された、
前記電気外科用脈管封止具。 - 前記共平面マイクロストリップアンテナが、
平面誘電体基板であって、前記対向する内面間の前記間隙に露出した上面と、前記平面誘電体基板の前記上面とは反対側の下面とを有する、前記平面誘電体基板と、
前記下面にある接地導体層と、
前記上面にあり、前記接地導体層に電気的に接続されている接地伝導性ストリップと、
前記上面にあるアクティブ伝導性ストリップであって、前記アクティブ伝導性ストリップが前記接地伝導性ストリップから離隔されている、前記アクティブ伝導性ストリップとを備え、
前記アクティブ伝導性ストリップと前記接地伝導性ストリップとが、前記1対のジョー間の前記領域の内側で均一の最近接間隔を有するように配置された、請求項1に記載の電気外科用脈管封止具。 - 前記アクティブ伝導性ストリップが、長手方向に延在する細長いフィンガー電極であり、
前記接地伝導性ストリップが、前記フィンガー電極の側面に位置し、かつ前記フィンガー電極の遠位端を囲むU字形要素である、請求項2に記載の電気外科用脈管封止具。 - 前記接地伝導性ストリップが、前記誘電体基板に形成されたスルーホールを介して、前記接地導体層に電気的に接続されている、請求項2または請求項3に記載の電気外科用脈管封止具。
- 前記1対のジョーが、アクティブジョーであって、その内部に取り付けられた前記エネルギー送達構造を有する前記アクティブジョーと、マイクロ波EMエネルギー供給を受けないパッシブジョーとを備える、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記パッシブジョーの前記内面が、前記間隙で、弾力のある変形可能な電気絶縁材料層を構成する、請求項5に記載の電気外科用脈管封止具。
- 前記1対のジョーの各ジョーが、その内部に取り付けられたそれぞれのエネルギー送達構造を有し、
前記遠位端組立品が、前記それぞれのエネルギー送達構造の間で、前記同軸伝送線路から受け取った前記マイクロ波EMエネルギーを分配するための電力分配器を含む、先行請求項のいずれかに記載の電気外科用脈管封止具。 - 前記対向する内面が、前記間隙内に生体組織を保持するための表面模様付き部分またはリッジ状部分を含む、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記1対のジョーが、前記同軸伝送線路の長手方向軸に対して横方向に伸びるヒンジ軸の周りを互いと相対的に枢動可能である、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記1対のジョーが、
前記器具シャフトに対して固定された静止ジョーと、
前記静止ジョーと相対的に枢動可能に取り付けられて、前記対向する内面間の前記間隙を開閉する可動ジョーと
を備える、先行請求項のいずれかに記載の電気外科用脈管封止具。 - 前記エネルギー送達構造が、前記静止ジョーの前記内面に配されている、請求項10に記載の電気外科用脈管封止具。
- 前記ブレードが、前記1対のジョーの近位に位置する引き込み位置と、前記ブレードが、前記1対のジョー間の前記領域の内側に位置する繰り出し位置との間で、前記ブレードが、長手方向に摺動自在である、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記ブレードが、前記1対のジョーに形成された長手方向に延在する凹溝に沿って摺動自在である、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記ブレードが、前記1対のジョーのうちの一方の内部に取り付けられ、
前記ブレードが、前記ジョーの前記内面の下に位置する引き込み位置と、前記ブレードが、前記1対のジョー間の前記領域の内側に位置する繰り出し位置との間で、前記ブレードが、横方向に摺動自在である、請求項1〜11のいずれか1項に記載の電気外科用脈管封止具。 - 前記ブレードが、生体組織の薄切りに適した鋭い縁を持つ剛性要素を備える、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記ブレードが、バイポーラ高周波切断要素、超音波ソノトロード、および加熱可能ワイヤ要素のいずれか1つを備える、請求項1〜14のいずれか1項に記載の電気外科用脈管封止具。
- 前記器具シャフトが、高周波(RF)EMエネルギーを伝えるように構成され、前記遠位端組立品が、前記器具シャフトから前記RFEMエネルギーを受け取るように構成され、
前記遠位端組立品が、生体組織を切り開くための前記RFEMエネルギーを送達するように構成された切開器要素を更に備え、
前記切開器要素が、前記1対のジョー間の前記領域の外側に位置している、先行請求項のいずれかに記載の電気外科用脈管封止具。 - マイクロ波電磁(EM)エネルギーおよび高周波(RF)EMエネルギーを伝えるように構成された器具シャフトと、
前記器具シャフトから前記マイクロ波EMエネルギーおよび前記RFEMエネルギーを受け取るように前記器具シャフトの遠位端に構成された遠位端組立品であって、
1対のジョーであって、その対向する内面の間の間隙を開閉するために互いと相対的に移動できる前記1対のジョーと、
生体組織を切り開くための前記RFEMエネルギーを送達するように構成された切開器要素と
を備えた、前記遠位端組立品と
を備える電気外科用脈管封止具であって、
前記1対のジョーが、前記対向する内面の間の前記間隙に前記マイクロ波EMエネルギーを放射するように構成されたエネルギー送達構造を備え、
前記エネルギー送達構造が、放射されたマイクロ波場を実質的に前記1対のジョー間の領域の内側に閉じ込めるように構成され、
前記切開器要素が、前記1対のジョー間の前記領域の外側に位置している、
前記電気外科用脈管封止具。 - 前記切開器要素が、アクティブ電極およびリターン電極を有するバイポーラRF構造を備える、請求項18に記載の電気外科用脈管封止具。
- 前記切開器要素が、組織に接触するための前縁を与える突出体を備え、
前記アクティブ電極が、前記前縁に設けられている、請求項19に記載の電気外科用脈管封止具。 - 前記リターン電極が、前記1対のジョーの前記外面にある、請求項19または請求項20に記載の電気外科用脈管封止具。
- 前記切開器要素が、前記1対のジョーの外面に取り付けられている、請求項17〜21のいずれか1項に記載の電気外科用脈管封止具。
- 前記切開器要素が、長手方向延長部に取り付けられ、前記長手方向延長部が、前記1対のジョーに対して長手方向に移動可能である、請求項17〜21のいずれか1項に記載の電気外科用脈管封止具。
- 前記切開器要素が、前記遠位端組立品の遠位端に取り付けられている、請求項17〜23のいずれか1項に記載の電気外科用脈管封止具。
- 前記器具シャフトが、前記マイクロ波EMエネルギーおよび前記RFEMエネルギーの両方を伝えるための共通信号経路を提供する同軸伝送線路を備え、
前記遠位端組立品が、前記切開器要素からの前記マイクロ波EMエネルギーを遮断するための誘導性フィルタと、前記1対のジョーにある前記エネルギー送達構造からの前記RFEMエネルギーを遮断するための容量性フィルタとを備える、請求項18〜24のいずれか1項に記載の電気外科用脈管封止具。 - 前記遠位端組立品および前記器具シャフトが、外科用スコープデバイスの器具チャネル内に嵌合するように寸法決めされた、先行請求項のいずれかに記載の電気外科用脈管封止具。
- 前記外科用スコープデバイスが、腹腔鏡である、先行請求項のいずれかに記載の電気外科用脈管封止具。
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