JP2021519150A - 心耳除外のためのデバイス - Google Patents
心耳除外のためのデバイス Download PDFInfo
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Abstract
Description
本願は、参照することによってその全体として本明細書に組み込まれる、2018年3月28日に出願された、米国仮出願第62/649,455号の優先権を主張する。
本開示は、締結具および/またはアプリケータの分野に広く関連する。より具体的には、本開示は、限定ではないが、ステープル等の滅菌された締結具を含む、インプラントおよび/または締結具の外科手術用アプリケータに関する。
心房細動は、左心房および右心房の非常に急速な心拍によって特徴付けられる、比較的に一般的な病状である。心房細動は、通常、それ自体が致命的ではないが、これは、増加される卒中のリスクと関連付けられている。急速な心拍は、血液を左心耳(LAA)内に貯留させ、これは、それらが大脳血管系に進入し得る場所から左心房の中に解放される、塞栓を引き起こし、したがって、卒中を引き起こすと考えられている。卒中に加えて、塞栓は、冠循環に進入し、潜在的に心筋梗塞を引き起こし得る、または末梢循環に進入し、潜在的に末梢血管疾患を引き起こし得る。
これらの理由から、LAAをシールするためのコンプライアント閉鎖デバイスとの併用のための改良された送達ツールを提供することが、望ましいであろう。さらに、送達ツールおよびそれらの使用方法が、他の組織閉鎖デバイスの送達と互換性があり、LAAの閉鎖に加えた手技のものである場合、さらに望ましいであろう。
ハンドルと、
トリガであって、トリガは、初期位置と、作動位置と、初期位置と作動位置との間の中間位置との間でハンドルに対して移動可能である、トリガと、
ロックアウト機構であって、ロックアウト機構は、係止位置と係止解除位置との間でトリガに対して移動可能であり、ロックアウト機構は、
トリガが、初期位置から作動位置に向かって移動されると、中間位置にトリガを係止することと、
ロックアウト機構が、係止位置から係止解除位置まで移動されると、中間位置から初期位置または作動位置に向かったトリガの移動を許可することと
を行うように動作可能に配列される、ロックアウト機構と
を備える、外科手術用アプリケータ。
トリガに接続される解放ボタンであって、解放ボタンは、トリガに対して第1の位置と第2の位置との間で移動可能である、解放ボタンと、
ハンドルに接続されるトリガ停止部であって、トリガ停止部は、ハンドルに対して第1の位置と第2の位置との間で移動可能である、トリガ停止部と、
を備える、付記1−4のいずれかに記載の外科手術用アプリケータ。
ハンドルと、
トリガであって、トリガは、初期位置と、作動位置と、初期位置と作動位置との間の中間位置との間でハンドルに対して移動可能である、トリガと、
ロックアウト機構であって、ロックアウト機構は、トリガに接続される解放ボタンと、ハンドルに接続されるトリガ停止部とを含む、ロックアウト機構と、
を備え、
初期位置から作動位置に向かったトリガの移動は、トリガ停止部をトリガと係合させ、中間位置にトリガを係止し、
トリガが、中間位置にあるとき、トリガに対する解放ボタンの移動は、トリガ停止部からトリガを係脱させ、中間位置から初期位置または作動位置に向かったトリガの移動を許可する、
外科手術用アプリケータ。
ハンドルと、
トリガであって、トリガは、初期位置と、作動位置と、初期位置と作動位置との間の中間位置との間でハンドルに対して移動可能である、トリガと、
ハンドルから遠位に延在する伸長体であって、伸長体は、遠位部分を有する、伸長体と、
伸長体の遠位部分における顎アセンブリであって、顎アセンブリは、トリガの移動を介して、開放位置と、閉鎖位置と、開放位置と閉鎖位置との間の中間位置との間で選択的に移動可能である、顎アセンブリと、
ロックアウト機構であって、
トリガが、初期位置から作動位置に向かって移動されると、中間位置にトリガおよび顎アセンブリを係止することと、
中間位置から初期位置または作動位置に向かったトリガの移動を許可し、それぞれ、中間位置から開放位置または閉鎖位置に向かって顎アセンブリを移動させることと
を行うように動作可能に配列される、ロックアウト機構と、
を備える、外科手術用アプリケータ。
トリガ上に、締結具アプリケータのハンドルに向かった方向に圧縮力を印加することによって、初期位置から作動位置に向かって締結具アプリケータのトリガを移動させることと、
トリガの移動を介して、開放位置から閉鎖位置に向かって締結具アプリケータの顎アセンブリを閉鎖することと、
ロックアウト機構を用いて中間位置にトリガおよび顎アセンブリを係止することと、
係止位置から係止解除位置までロックアウト機構を移動させることと、
中間位置から作動位置に向かってトリガを移動させることと、
トリガの移動を介して中間位置から閉鎖位置まで顎アセンブリを閉鎖することと
を含む、方法。
「左」、「右」、「内側」、「外側」、「上方」、「下方」、および同等物等の空間または方向を示す用語は、本発明が、種々の代替配向を想定し得るため、限定するものとして見なされるべきではない。説明の目的のために、以降、用語「端部」、「上側」、「下側」、「右」、「左」、「垂直」、「水平」、「上部」、「底部」、「横」、「縦」、およびそれらの派生語は、図面内に配向されるように、本発明に関連するものとする。
Claims (32)
- 締結具のための外科手術用アプリケータであって、前記外科手術用アプリケータは、
ハンドルと、
トリガであって、前記トリガは、初期位置と、作動位置と、前記初期位置と前記作動位置との間の中間位置との間で前記ハンドルに対して移動可能である、トリガと、
ロックアウト機構であって、前記ロックアウト機構は、係止位置と係止解除位置との間で前記トリガに対して移動可能であり、前記ロックアウト機構は、
前記トリガが、前記初期位置から前記作動位置に向かって移動されると、前記中間位置に前記トリガを係止することと、
前記ロックアウト機構が、前記係止位置から前記係止解除位置まで移動されると、前記中間位置から前記初期位置または前記作動位置に向かった前記トリガの移動を許可することと
を行うように動作可能に配列される、ロックアウト機構と
を備える、外科手術用アプリケータ。 - 前記ロックアウト機構はさらに、前記ロックアウト機構が、前記初期位置からの前記トリガの移動に先立って前記係止位置から前記係止解除位置まで移動されると、前記初期位置から前記作動位置までの前記トリガの移動を許可するように動作可能に配列される、請求項1に記載の外科手術用アプリケータ。
- 前記トリガは、前記トリガ上への前記ハンドルに向かった方向への圧縮力の印加に伴って、前記初期位置から前記ハンドルに対して移動可能である、請求項1に記載の外科手術用アプリケータ。
- 前記トリガは、前記ハンドルに面する近位側の反対の遠位側を有し、前記ロックアウト機構の少なくとも一部は、前記トリガの遠位側に位置付けられる、請求項1に記載の外科手術用アプリケータ。
- 前記ロックアウト機構は、
前記トリガに接続される解放ボタンであって、前記解放ボタンは、前記トリガに対して第1の位置と第2の位置との間で移動可能である、解放ボタンと、
前記ハンドルに接続されるトリガ停止部であって、前記トリガ停止部は、前記ハンドルに対して第1の位置と第2の位置との間で移動可能である、トリガ停止部と
を備える、請求項1に記載の外科手術用アプリケータ。 - 前記解放ボタンは、前記トリガに対して枢動可能に移動可能である、請求項4に記載の外科手術用アプリケータ。
- 前記解放ボタンは、前記トリガに対して側方の方向に線形に移動可能である、請求項4に記載の外科手術用アプリケータ。
- 前記解放ボタンは、解放ボタン付勢部材によって前記第1の位置に付勢される、請求項4に記載の外科手術用アプリケータ。
- 前記トリガ停止部は、トリガ停止部付勢部材によって前記第1の位置に付勢される、請求項4に記載の外科手術用アプリケータ。
- 前記初期位置から前記作動位置に向かった前記トリガの移動は、前記トリガを前記トリガ停止部と係合させ、前記中間位置に前記トリガを自動的に係止する、請求項4に記載の外科手術用アプリケータ。
- 前記トリガが前記中間位置にあるときの前記第1の位置から前記第2の位置までの前記解放ボタンの移動は、前記トリガ停止部からの前記トリガの係脱を許可する、請求項4に記載の外科手術用アプリケータ。
- ラチェット機構をさらに備え、前記ラチェット機構は、前記トリガが、前記中間位置から前記作動位置に向かって移動されると、前記トリガに係合し、前記初期位置に向かった前記トリガの移動を防止する、請求項1に記載の外科手術用アプリケータ。
- 前記ラチェット機構は、前記トリガが、前記作動位置まで移動されると、前記トリガから係脱する、請求項12に記載の外科手術用アプリケータ。
- 前記ラチェット機構は、ラチェットロッドと、ラチェットとを備え、前記ラチェットは、前記トリガが前記中間位置から前記作動位置に向かって移動されると、前記ラチェットロッドと係合される、請求項12に記載の外科手術用アプリケータ。
- 前記ラチェット機構は、前記トリガが、前記中間位置から前記作動位置に向かって所定の距離だけ移動されると、作動される、請求項12に記載の外科手術用アプリケータ。
- 顎アセンブリをさらに備え、前記顎アセンブリは、前記初期位置から前記作動位置までの前記トリガの移動を介して、開放位置と閉鎖位置との間で選択的に移動可能である、請求項1に記載の外科手術用アプリケータ。
- 前記顎アセンブリは、相互に移動可能に取り付けられる一対の顎状部を備え、各顎状部は、各側面を通して延在する複数の側方スロットを伴う一対の側面を有する、請求項16に記載の外科手術用アプリケータ。
- 各顎状部の前記側面のうちの少なくとも1つの外部表面が、陥凹を有する、請求項17に記載の外科手術用アプリケータ。
- 前記陥凹は、前記複数の側方スロットのうちの少なくとも一部を封入するカバー要素を受容する、請求項18に記載の外科手術用アプリケータ。
- 前記カバー要素は、前記陥凹の中に接着して固着される、請求項19に記載の外科手術用アプリケータ。
- 前記顎状部は、ピンによって相互に枢動可能に取り付けられる、請求項17に記載の外科手術用アプリケータ。
- 減衰機構をさらに備え、前記減衰機構は、前記トリガと動作可能に配列され、前記初期位置と前記作動位置との間での移動の間に前記トリガ上に印加される圧縮力の変動を減衰させる、請求項1に記載の外科手術用アプリケータ。
- 前記減衰機構は、ばねと、ダンパとを含む、請求項22に記載の外科手術用アプリケータ。
- 締結具のための外科手術用アプリケータであって、前記外科手術用アプリケータは、
ハンドルと、
トリガであって、前記トリガは、初期位置と、作動位置と、前記初期位置と前記作動位置との間の中間位置との間で前記ハンドルに対して移動可能である、トリガと、
ロックアウト機構であって、前記ロックアウト機構は、前記トリガに接続される解放ボタンと、前記ハンドルに接続されるトリガ停止部とを含む、ロックアウト機構と
を備え、
前記初期位置から前記作動位置に向かった前記トリガの移動は、前記トリガ停止部を前記トリガと係合させ、前記中間位置に前記トリガを係止し、
前記トリガが、前記中間位置にあるとき、前記トリガに対する前記解放ボタンの移動は、前記トリガ停止部から前記トリガを係脱させ、前記中間位置から前記初期位置または前記作動位置に向かった前記トリガの移動を許可する、外科手術用アプリケータ。 - ラチェット機構をさらに備え、前記ラチェット機構は、前記トリガが、前記中間位置から前記作動位置に向かって移動されると、前記トリガに係合し、前記初期位置に向かった前記トリガの移動を防止する、請求項24に記載の外科手術用アプリケータ。
- 前記ラチェット機構は、前記トリガが、前記作動位置まで移動されると、前記トリガから係脱する、請求項25に記載の外科手術用アプリケータ。
- 締結具のための外科手術用アプリケータであって、前記外科手術用アプリケータは、
ハンドルと、
トリガであって、前記トリガは、初期位置と、作動位置と、前記初期位置と前記作動位置との間の中間位置との間で前記ハンドルに対して移動可能である、トリガと、
前記ハンドルから遠位に延在する伸長体であって、前記伸長体は、遠位部分を有する、伸長体と、
前記伸長体の遠位部分における顎アセンブリであって、前記顎アセンブリは、前記トリガの移動を介して、開放位置と、閉鎖位置と、前記開放位置と前記閉鎖位置との間の中間位置との間で選択的に移動可能である、顎アセンブリと、
ロックアウト機構であって、
前記トリガが、前記初期位置から前記作動位置に向かって移動されると、前記中間位置に前記トリガおよび前記顎アセンブリを係止することと、
前記中間位置から前記初期位置または前記作動位置に向かった前記トリガの移動を許可し、それぞれ、前記中間位置から前記開放位置または前記閉鎖位置に向かって前記顎アセンブリを移動させることと
を行うように動作可能に配列される、ロックアウト機構と
を備える、外科手術用アプリケータ。 - 締結具アプリケータを動作させる方法であって、前記方法は、
前記トリガ上に、前記締結具アプリケータのハンドルに向かった方向に圧縮力を印加することによって、初期位置から作動位置に向かって前記締結具アプリケータのトリガを移動させることと、
前記トリガの移動を介して、開放位置から閉鎖位置に向かって前記締結具アプリケータの顎アセンブリを閉鎖することと、
ロックアウト機構を用いて中間位置に前記トリガおよび前記顎アセンブリを係止することと、
係止位置から係止解除位置まで前記ロックアウト機構を移動させることと、
前記中間位置から前記作動位置に向かって前記トリガを移動させることと、
前記トリガの移動を介して前記中間位置から前記閉鎖位置まで前記顎アセンブリを閉鎖することと
を含む、方法。 - 前記顎アセンブリを前記閉鎖位置まで閉鎖することは、締結具を非固定位置から固定位置まで閉鎖する、請求項28に記載の方法。
- 前記トリガが、前記中間位置から前記作動位置に向かって移動された後、前記初期位置に向かった移動から、ラチェット機構を介して前記トリガを遮断することをさらに含む、請求項28に記載の方法。
- 前記顎アセンブリは、前記トリガが、前記作動位置まで移動された後、前記閉鎖位置から前記開放位置に向かって移動する、請求項28に記載の方法。
- 前記トリガが、前記作動位置まで移動されると、前記トリガを係止解除することをさらに含む、請求項28に記載の方法。
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- 2019-03-27 JP JP2020551904A patent/JP7348199B2/ja active Active
- 2019-03-27 US US16/366,738 patent/US11653928B2/en active Active
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AU2019243731A1 (en) | 2020-10-08 |
US11653928B2 (en) | 2023-05-23 |
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JP7348199B2 (ja) | 2023-09-20 |
EP3773256A4 (en) | 2021-12-15 |
CN112074240A (zh) | 2020-12-11 |
JP2023144125A (ja) | 2023-10-06 |
US20190298381A1 (en) | 2019-10-03 |
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US20230270443A1 (en) | 2023-08-31 |
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