JP2747342B2 - 外科用ステープラのためのエネルギー蓄積手段 - Google Patents

外科用ステープラのためのエネルギー蓄積手段

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Publication number
JP2747342B2
JP2747342B2 JP1246610A JP24661089A JP2747342B2 JP 2747342 B2 JP2747342 B2 JP 2747342B2 JP 1246610 A JP1246610 A JP 1246610A JP 24661089 A JP24661089 A JP 24661089A JP 2747342 B2 JP2747342 B2 JP 2747342B2
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Japan
Prior art keywords
stapler
jaw
handle
jaws
tissue
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JP1246610A
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JPH02243138A (ja
Inventor
ウイリアム・デイ・フオツクス
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Ethicon Inc
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Ethicon Inc
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

【発明の詳細な説明】 発明の分野 本発明は、一般に、直線状の外科用ステープラの切断
を開始するための改良された方法に関する。さらに具体
的に、本発明は、バネ作動のカム付きハンドルにおいて
蓄積されたポテンシャル・エネルギーを作動させること
により、外科用ステープラにおける切断の開始を改良す
ることに関する。
本発明を要約すれば、蓄積されたポテンシャル・エネ
ルギーを内部器官のステープラにおけるドライバーとカ
ッターに伝える開始手段である。また、ステープラのあ
ごの互いの適正な締め付けまで、そのような装置の使用
を防止するオーバーライド手段が開示される。
発明の背景 最近、外科用ステープラが、医療による創傷を閉鎖す
る使用の一般的なモードになった。開発された外科用ス
テープラの幾つかは、ステープルの列の間で組織を切断
する装置である。組織が切断され、一方、ステープル
は、創傷を密封するために、組織を通って駆動される。
これは、胃腸内装置において特に言える。
現在使用される外科用ステープル及び切断装置の一つ
の欠点は、切断手順を開始する難しさである。即ち、一
般に、ステープラは、一対のあごから成り、それらの間
に、組織が置かれ、切断され、かつステープルで留めら
れる。あごは、組織の回りを締め付け、そして切断及び
ステープル手順が開始される。通常、切断を開始するた
めに、使用者は、ナイフ刃において余分の力を及ぼすこ
とを必要とする。この点において、ナイフ刃は、組織を
初期的に分離する際に困難を有する。一旦切断が開始さ
れたならば、残りの組織を切断することは、ずっと容易
になる。このため、切断を開始する瞬間にのみ、付加的
な力が必要とされる。
発明の要約 このため、切断の開始の瞬間においてエネルギーを初
期的に増大させるステープラを提供することが、本発明
の目的である。このため、ナイフ刃の作動器の近くにポ
テンシャル・エネルギーを蓄積することが、本発明の目
的である。
ステープラの使用の準備ができるまで、ポテンシャル
・エネルギーの使用を許容することなく、作動器の近く
にポテンシャル・エネルギーを蓄積することが、本発明
のいっそうの目的である。
切断のための行程の開始により、組織を切断する力を
増大させることにより、外科用ステープラにおいて滑ら
かな切断力を提供することが、本発明のさらに別の目的
である。
本発明のこれらと他の目的は、エネルギーが蓄積され
るステープル及び切断手段と、ポテンシャル・エネルギ
ーをステープラとカッターの開始手段に伝えることがで
きるエネルギー蓄積手段とを有する外科用ステープラに
おいて達成される。ポテンシャル・エネルギーの伝達に
より、該開始手段は、開始手段に対して組織によって伝
えられた抵抗に打ち勝つことができる。さらに、オーバ
ーライド手段は、外科用ステープラのあごが互いに確実
に締め付けられるまで、ステープラの発火を防止するた
めに設けられる。
図面の詳細な説明 本発明の目的は、次の図面に記載された如く、発明の
次の詳細な説明によりさらに明確に理解される。
第1図、第2図と第3図を参照すると、下方又は第1
あご22と、上方又は第2あご24とを含むステープラ10が
示される。あご22、24は、ステープラ本体20を形成す
る。あごの内側に、図示されていないが、組織が保持さ
れる。ハンドル42が、ステープラ10の脚に沿って駆動さ
れる時、駆動手段12が作動される。案内板51は、駆動手
段を動作させるために、嵌合棒11内に適合される。駆動
手段12は、楔16とナイフ刃18を含む。楔16とナイフ18
は、ステープル・カートリッジ30におけるスロット32を
通過する。楔16は、図示されていないドライバーを作動
させ、ステープルをカートリッジ30におけるステープル
・キャリヤ100を通って、上方又は第2あご24の表面に
おけるアンビルへと駆動させる。ステープラ10がステー
プルを駆動している時、ナイフ刃18が、組織を切断す
る。こうして、ハンドル42の一行程の最後において、組
織内に二列のステープルが形成され、組織は、これら二
列の間で切断される。本ステープラ10への改良は、最も
基本的には、開始手段40へのハンドル42の転換において
見られる。開始手段40内に、ハンドル42に組み込まれた
第1戻り止め手段50がある。これは、第5図に最良に見
られる。第1戻り止め手段50は、ハンドル42に沿った旋
回軸52の回りで旋回する。戻り止め手段50は、第3図に
見られた如く、ステープラ10の下方又は第1あご22にお
けるスロット68内に置かれる合くぎ又は柱54を含む。
さらに、一つの好ましい実施態様において、一方の端
部において下方あご22に沿って取り付けられたバネ73
が、第4図に見られる。バネ73はまた、エネルギー蓄積
手段70における穴81内に適合される取り付け柱79におい
て、エネルギー蓄積手段70に取り付けられる。エネルギ
ー蓄積手段70はまた、バネ72によって、案内室26内の下
方あご22にバネ負荷される。バネ72、73は、開始手段40
が負荷位置にある時、ポテンシャル・エネルギーを蓄積
する。
エネルギー蓄積手段70はまた、溝76を備えたカム74を
含む。カム74は、第4図乃至第9図に最良に見られた如
く、旋回軸78の回りに案内室26上で旋回する。切断及び
ステープル行程の開始中、付加的なエネルギーをカッタ
ー18と楔16に開始手段40により供給させるのは、エネル
ギー蓄積手段70である。
また、第9図と共に第4図に見られた如く、オーバー
ライド又は第2戻り止め手段80がある。オーバーライド
手段80は、案内室26に対して負荷を与えるバネ82を具備
する。また、旋回軸84の回りで回転する鈎棒86が見られ
る。鈎棒86は、第6図と第7図に最良に見られた如く、
駆動手段12の嵌合用溝88内に適合する湾曲した端部を有
する。オーバーライド手段は、下方あご22のレバー60内
に置かれたペグ90によって作動されることができる。第
1戻り止め手段50の作動に対してオーバーライド手段80
を非作動にするのは、このペグ90であり、エネルギー蓄
積手段70により、行程の開始において開始手段40にポテ
ンシャル・エネルギーを提供させる。
このため、本発明は、次の如く実施される。最初に、
組織が、二つのあご22、24の間に置かれる。レバー60
が、嵌合用ノッチ66と縦列のピン64の回りのクランプ62
を使用して、締め付けられる。この点において、第1戻
り止め手段50の合くぎ54は、下方あご22の案内室26にお
けるスロット68におらかじめ挿入されている。一旦組織
が保持されるならば、開始手段40が、前方に(あご22、
24の端部の方に)移動され、駆動手段12によりエネルギ
ー蓄積手段70を作動させる。それからエネルギー蓄積手
段70が、プッシャー・ブロック13がカムを回すために溝
76に接触する時、回転される。バネ72、73は、蓄積され
たポテンシャル・エネルギーを解放する準備ができる。
また、ステープラ10は、切断及びステープル使用のため
の準備ができる。
ステープラは、レバー60のペグ90が、オーバーライド
手段80を非作動した場合のみ、使用される。これは、ペ
グ90が、レバー60の適正な締め付けにより、最大距離を
回転された時、発生する。オーバーライド80の鈎棒86
が、駆動手段12に位置する嵌合用溝88内に置かれること
に注意すること。鈎棒86が、嵌合用溝88の外側で変位さ
れるのは、ペグ90が、旋回軸84の回りにオーバーライド
手段80を旋回させる場合のみである。その時のみ、第2
戻り止め手段80が、非作動にされる。また、その時のみ
ステープラ10は、第1戻り止め手段50が使用を許容す
る。
この点において、第1戻り止め手段50は、ハンドル42
の使用を許容するために、旋回軸52の回りで旋回される
ことができる。それからバネ72、73に蓄積されたエネル
ギーは、カム74により、駆動手段12のプッシャー・ブロ
ック13に蓄積されたポテンシャル・エネルギーを伝えさ
せる。この蓄積されたポテンシャル・エネルギーは、カ
ッター18とステープル用楔16に開始エネルギーを伝えさ
せる。この蓄積されたポテンシャル・エネルギーは、切
断及びステープル行程をより容易に開始させ、より良
好、容易、かつ正確なステープル及び切断を許容する。
このため、本発明は、付加的な開始エネルギーを必要
とするすべてのステープラ、特に、切断装置を使用する
ステープラにおいて、使用される。また、本発明が、好
ましい実施態様に関連して記載されたが、その範囲は、
実質的に類似機能を実質的に同一の方法において実施す
る発明への修正を包含することが理解される。さらに、
発明は、特許請求の範囲に関連して記載されたことが認
識される。
本発明の主なる特徴及び態様は以下のとおりである。
1.ステープルを組織内に駆動するための駆動手段を作動
させることができる開始手段を有する外科用ステープラ
において、ポテンシャル・エネルギーを該開始手段に伝
えることがでるエネルギー蓄積手段を具備し、該伝達エ
ネルギーにより、該開始手段は、該開始手段に対して該
組織によって伝えられた力に打ち勝つことを特徴とする
外科用ステープラ。
2.該エネルギー蓄積手段が、溝を備えたカム手段と該ス
テープラの本体とに連結されたバネ手段を具備し、該バ
ネ手段が、使用者によって伝えられるポテンシャル・エ
ネルギーを有することができ、該ポテンシャル・エネル
ギーが、該ステープラ本体に取り付けられた第1戻り止
め手段によって該カム手段における所定位置に保持さ
れ、かつ使用の準備ができるまで、該ステープラにおけ
る所定位置に該開始手段を保持することができ、該開始
手段は、使用中、該戻り止め手段と該ポテンシャル・エ
ネルギーを該開始手段に変位させることができる上記1
に記載の外科用ステープラ。
3.該開始手段が、該駆動手段に連結されたハンドル手段
を具備し、該ハンドル手段は、該エネルギー蓄積手段の
該カム手段に挿入される合くぎにおいて終端し、そして
該第1戻り止め手段の解除まで、該溝内に保持される上
記2に記載の外科用ステープラ。
4.該第1戻り止め手段が、該ハンドル手段において旋回
可能であり、かつ該ステープラ本体におけるスロットに
挿入されるペグにおいて極点に達し、該ステープラが使
用のための準備ができるまで、該ハンドル手段と該エネ
ルギー蓄積手段を安定に保持し、これにより該第1戻り
止め手段は、該スロットから旋回により外され、そして
該ポテンシャル・エネルギーが、該ハンドル手段に伝え
られる上記3に記載の外科用ステープラ。
5.該ステープラが、該組織の回りに適合するために、第
2あごに取り付けられた第1あごを具備し、さらに、該
あごが互いに適正に取り付けられるまで、該エネルギー
蓄積手段を所定位置において保持することができるオー
バーライド手段を具備する上記1に記載の外科用ステー
プラ。
6.該第1あごが、該第1あごにおけるレバーを作動させ
るクランプにより、該第2あごに取り付けられ、該オー
バーライド手段は、該駆動手段にバネ負荷され、かつ挿
入される第2戻り止め手段を具備し、該第2戻り止め手
段は、該第1及び第2あごの閉鎖により、該レバーに位
置するペグとの接触により、該駆動手段から旋回により
外される上記5に記載の外科用ステープラ。
7.該第2戻り止め手段が、該駆動手段上に位置する嵌合
用溝上に留められることができる鈎棒を具備する上記6
に記載の外科用ステープラ。
8.該ステープラが、該組織の回りに適合するために、第
2あごに取り付けられた第1あごを具備し、さらに、該
あごが互いに適正に取り付けられるまで、該エネルギー
蓄積手段と該切断手段を所定位置において保持すること
ができるオーバーライド手段を具備する上記4に記載の
外科用ステープラ。
9.該第1あごが、該第1あごにおけるレバーを作動させ
るクランプにより、該第2あごに取り付けられ、該オー
バーライド手段が、該駆動手段にバネ負荷され、かつ挿
入される第2戻り止め手段を具備し、該第2戻り止め手
段は、該第1及び第2あごの閉鎖の際に、該レバー上に
位置するペグとの接触により、該駆動手段から旋回によ
り外される上記8に記載の外科用ステープラ。
10.該第2戻り止め手段が、該駆動手段上に位置する嵌
合用溝上に留められることができる鈎棒を具備し、該第
2戻り止め手段が該駆動手段から旋回により外されるま
で、該駆動手段を所定位置において保持する上記9に記
載の外科用ステープラ。
11.該第1あごにおけるレバーによって作動されるクラ
ンプにより、第2あごに取り付けられる第1あごと、 該あごの間に置かれた組織内に、該あごの一方に位置す
るステープルを駆動するための駆動手段と、該ステープ
ラ内で該駆動手段を案内するために、該駆動手段に連結
されたハンドルとを具備し、 該駆動手段が、負荷用バネによって該あごの一方に取り
付けられたカム手段内に挿入可能であり、該ハンドル
が、該あごの一方内のスロットに挿入可能な合くぎを有
し、該ステープラが使用の準備ができるまで、該ハンド
ルと該負荷バネを所定位置に保持し、これにより該合く
ぎは、該スロットから旋回により外され、そして該バネ
からのポテンシャル・エネルギーが、該カム手段によっ
て該駆動手段に伝えられ、該駆動手段と該ハンドルに対
して該組織によって伝えられた力に打ち勝つことを特徴
とする外科用ステープラ。
12.該第1あごが、さらに、該レバーにおけるペグと、
該駆動手段における嵌合用溝にバネ負荷され、かつ旋回
される鈎棒とを具備し、該鈎棒は、該ペグが、該ステー
プラの該第2あごへの該第1あごの適正な締め付けの際
に、該嵌合用溝から該鈎棒を旋回により外すまで、該ス
テープラ内に該駆動手段を保持する上記11に記載の外科
用ステープラ。
13.該鈎棒の旋回が、該ハンドルを該スロットから外さ
せ、そして該カム手段による該ポテンシャル・エネルギ
ーの伝達が、該駆動手段とハンドルにおいてバネ作用さ
せる上記12に記載の外科用ステープラ。
14.駆動手段と、該駆動手段を開始させるための手段と
を有する外科用ステープラにおいて、ステープルに対す
る組織による力に打ち勝つための方法において、 該ステープラがステープルの準備ができるまで、該開始
手段においてポテンシャル・エネルギーを蓄積し、次い
で該ポテンシャル・エネルギーを該開始手段を通して該
駆動手段に伝えることを特徴とする方法。
【図面の簡単な説明】
第1図は、本発明の好ましい実施態様の一部であるハン
ドルを組み込む外科用ステープラの斜視図。 第2図は、本発明のハンドルの正面図。 第3図は、本発明の好ましい実施態様の分解された斜視
図。 第4図は、本発明の好ましい実施態様を使用する下方あ
ご機構の分解された斜視図。 第5図は、本発明の好ましい実施態様の正面図。 第6図、第7図と第8図は、それぞれ、非負荷、負荷、
及び発火位置における本発明の正面図。 第9図は、本発明の好ましい実施態様のオーバーライド
機構の切り欠き平面図。

Claims (1)

    (57)【特許請求の範囲】
  1. 【請求項1】該第1あごにおけるレバーによって作動さ
    れるクランプにより、第2あごに取り付けられる第1あ
    ごと、 該あごの間に置かれた組織内に、該あごの一方に位置す
    るステープルを駆動するための駆動手段と、該ステープ
    ラ内で該駆動手段を案内するために、該駆動手段に連結
    されたハンドルとを具備し、 該駆動手段が、負荷用バネによって該あごの一方に取り
    付けられたカム手段内に挿入可能であり、該ハンドル
    が、該あごの一方内のスロットに挿入可能な合くぎを有
    し、該ステープラが使用の準備ができるまで、該ハンド
    ルと該負荷バネを所定位置に保持し、これにより該合く
    ぎは、該スロットから旋回により外され、そして該バネ
    からのポテンシャル・エネルギーが、該カム手段によっ
    て該駆動手段に伝えられ、該駆動手段と該ハンドルに対
    して該組織によって伝えられた力に打ち勝つことを特徴
    とする外科用ステープラ。
JP1246610A 1988-09-26 1989-09-25 外科用ステープラのためのエネルギー蓄積手段 Expired - Lifetime JP2747342B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US07/249,537 US4869415A (en) 1988-09-26 1988-09-26 Energy storage means for a surgical stapler
US249537 1988-09-26

Publications (2)

Publication Number Publication Date
JPH02243138A JPH02243138A (ja) 1990-09-27
JP2747342B2 true JP2747342B2 (ja) 1998-05-06

Family

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JP1246610A Expired - Lifetime JP2747342B2 (ja) 1988-09-26 1989-09-25 外科用ステープラのためのエネルギー蓄積手段

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Country Link
US (1) US4869415A (ja)
EP (1) EP0365153B1 (ja)
JP (1) JP2747342B2 (ja)
AU (1) AU620147B2 (ja)
CA (1) CA1316066C (ja)
DE (1) DE68923927T2 (ja)
ES (1) ES2077583T3 (ja)
GR (1) GR1000792B (ja)
IE (1) IE67892B1 (ja)
PT (1) PT91810B (ja)

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US4606343A (en) 1980-08-18 1986-08-19 United States Surgical Corporation Self-powered surgical fastening instrument

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US4608981A (en) * 1984-10-19 1986-09-02 Senmed, Inc. Surgical stapling instrument with staple height adjusting mechanism
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Also Published As

Publication number Publication date
AU4174889A (en) 1990-03-29
DE68923927D1 (de) 1995-09-28
EP0365153A1 (en) 1990-04-25
DE68923927T2 (de) 1996-03-21
PT91810A (pt) 1990-03-30
GR1000792B (el) 1992-12-30
ES2077583T3 (es) 1995-12-01
AU620147B2 (en) 1992-02-13
JPH02243138A (ja) 1990-09-27
US4869415A (en) 1989-09-26
IE893060L (en) 1990-03-26
GR890100603A (en) 1990-10-31
EP0365153B1 (en) 1995-08-23
CA1316066C (en) 1993-04-13
PT91810B (pt) 1995-07-18
IE67892B1 (en) 1996-05-01

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