JP3165206B2 - 外科手術用ステープラー - Google Patents

外科手術用ステープラー

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Publication number
JP3165206B2
JP3165206B2 JP33938791A JP33938791A JP3165206B2 JP 3165206 B2 JP3165206 B2 JP 3165206B2 JP 33938791 A JP33938791 A JP 33938791A JP 33938791 A JP33938791 A JP 33938791A JP 3165206 B2 JP3165206 B2 JP 3165206B2
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JP
Japan
Prior art keywords
cutting means
cartridge
slot
staples
stapler
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
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JP33938791A
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English (en)
Other versions
JPH0538341A (ja
Inventor
デイル・アール・シュルツ
ジョン・エイ・シャーマン
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Ethicon Inc
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Ethicon Inc
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Classifications

    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
    • B25C—HAND-HELD NAILING OR STAPLING TOOLS; MANUALLY OPERATED PORTABLE STAPLING TOOLS
    • B25C5/00—Manually operated portable stapling tools; Hand-held power-operated stapling tools; Staple feeding devices therefor
    • B25C5/16—Staple-feeding devices, e.g. with feeding means, supports for staples or accessories concerning feeding devices
    • B25C5/1686—Staple-feeding devices, e.g. with feeding means, supports for staples or accessories concerning feeding devices using pre-loaded cassettes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B17/07207—Surgical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical 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
    • A61B2017/07214—Stapler heads
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2945—Curved jaws
    • 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
    • A61B2090/0814—Preventing re-use

Landscapes

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

Description

【発明の詳細な説明】
【０００１】
【産業上の利用分野】本発明は使用済みステープルカー
トリッジの再発射を阻止する改良型外科手術用ステープ
ラーに関する。更に詳しく言えば、本発明は、使用済み
ステープルカートリッジの再発射を阻止する低価格で単
純な信頼性の高い自動係止機構を包含する。
【０００２】
【技術的背景】外科手術用ステープラーが導入される以
前は、外科医は患者の組織を縫い合わせるために多大な
時間を費やさなければならなかった。これが、手術手順
の最も時間を浪費する部分であった。外科手術用ステー
プラーは、医師が組織を縫い合わせるのに使用する時間
を減少させた。
【０００３】更に別の心配事は、手術中使用するステー
プラーが無菌であるか否かである。再使用可能なステー
プラーは、相対的に複雑な機械装置であるため、使用後
に滅菌することは困難である。従って、外科手術用ステ
ープラーは使い捨てであることが望ましい。外科手術中
には１個以上の外科手術用ステープラーが必要となるこ
とがあるため、経済的な理由から、再装填可能なステー
プルカートリッジを有する使い捨て外科手術用ステープ
ラーが開発された。
【０００４】手術室の作業員が、手術中に使い捨てステ
ープラーに未使用のステープルカートリッジを迅速に再
装填できることが望ましい。ステープラーを再装填する
時間が減少すれば、手術全体に費やす時間も短縮するの
で、このことは重要である。これは、手術時間が短縮さ
れれば患者のリスクも減少することを意味している。例
えば、手術時間が短縮されれば患者の麻酔時間もそれ程
長くはなくなる。しかし、使用済のカートリッジが不注
意でステープラーに再装填されたり、使用済のカートリ
ッジが、ステープラーを使用しようとする以前に除去さ
れていない時には手術が遅れる。
【０００５】ステープラーには種々の型がある。ステー
プルで留める機能のみを実施するステープラーもある
し、更に別の機能を実施するステープラーもある。例え
ば、ある型の外科手術用ステープラーは、平行列のステ
ープラーを有し、切断手段がステープル列間を移動する
ためのスロットを設けている。この型の外科手術用ステ
ープラーは、切断手段がステープル間の組織を貫通する
につれて、周囲の組織層に外側列のステープルを使用す
ることによって、出血を最小限に抑えている。このよう
なステープラーでは、使用済カートリッジがステープラ
ー内にあることが確認されなかった場合、医師は、ナイ
フによる切開部分に沿ってステープルを挿入できないの
に組織を切断してしまう可能性がある。
【０００６】このようなことが起こることを懸念する結
果、手術の遅延と患者への危害を減少する係止機構付き
使い捨て外科手術用ステープラーを提供する試みがなさ
れた。残念なことに、これらのステープラーの係止機構
は低価でも単純でもなく、必ずしも信頼性の高いもので
はなかった。
【０００７】例えば、グリーンの米国特許第４，０８
６，９２６号（以下「グリーン」と記載）では、装填中
にそれ自体を係止する手段を包含するカートリッジを有
し、例えば、全ステープルがカートリッジより放出され
る時に、不注意で器官構造物を切断するのを阻止するス
テープラーが開示されている。グリーンは、カートリッ
ジ内で実施される複雑なステープルカートリッジ係止装
置を開示している。グリーンのカートリッジは、レール
装置と、曲げ台手段と、細長い本体と、細長い本体内に
配設されている一対のベルトと、前述のベルトにより運
ばれる複数個の外科手術用ステープルと、一対の押し出
し物と、ランプ手段と、ナイフと、前記ナイフに付随す
る移動装置とを包含する。カートリッジがこれらの全要
素を有するため、複雑で、製造も相対的に高くつく。
【０００８】
【発明の概要】本発明による外科手術用のステープラー
は、使い捨てカートリッジ内に収納されている複数本の
列のステープルに使用するために提供されている。カー
トリッジは、ステープルの列の全長を実質的に延在する
隣接する列のステープル間に配設されているスロットを
有する。ステープラーは、ステープル発射手段と、スロ
ット内可動の切断手段とを包含する。切断手段は底面と
頂面と切断刃とを有する。ステープラーは、また、切断
手段がスロット内に移動するのを阻止する係止機構も包
含する。係止機構は、ステープラー内に配設されてお
り、切断手段を第一の位置内に置くために切断手段の底
面と係合する板バネから構成されている。第一の位置で
の切断手段は、スロットと一直線上には並ばない。ま
た、切断手段の頂面と係合する、カートリッジ上に配設
される手段もある。切断手段の頂面と係合する手段は、
板バネを押さえ、切断手段を第一の位置より第二の位置
へと移動させる。第二の位置での切断手段は、スロット
と一直線上に並ぶため、切断手段はスロット内に移動可
能である。
【０００９】本外科手術用ステープラーの一実施例にお
いて、切断手段の頂面と係合する、カートリッジ上に配
設される手段は、切断手段を第一の位置より第二の位置
に移動させる回転可能部材である。
【００１０】本外科手術用ステープラーの別の実施例で
は、切断手段の頂面と係合する、カートリッジ上に配設
される手段は、カートリッジスロットの前部近くで始ま
り、実質的に、カートリッジスロットの全長に沿って、
ステープルカートリッジの後部にまで配設されている形
成ワイヤ部材である。この実施例は、ワイヤ部材と共働
して切断手段を第一の位置より第二の位置に移動させる
ステープルカートリッジ内に成形される空洞を包含す
る。
【００１１】本外科手術用ステープラーの更に別の実施
例では、切断手段の頂面と係合する、カートリッジ上に
配設される手段は、分離可能な部材である。この部材
は、切断手段を第一の位置より第二の位置に移動させた
時に分離する。
【００１２】本発明の外科手術用ステープラーの好適な
実施例は、カートリッジスロット両側上の隣接する２列
のステープラーを有する。また、好適な実施例では、切
断手段はナイフ刃アセンブリである。
【００１３】
【実施例】本発明の特別の実施例を、添付図１〜１３を
参照に詳細に記載する。
【００１４】図１を参照にすれば、典型的な外科手術用
ステープラー２０は、上部片３０と発射手段４０と下部
片５０とステープルカートリッジ６０とから成る。
【００１５】ステープルカートリッジ６０は、下部片５
０内に密着する。特に、ステープルカートリッジ６０の
前部は下部ジョー溝５４内に密着する。更に詳しく言え
ば、ステープルカートリッジ６０の平行側壁６１は、下
部ジョー溝５４内に密着する。ステープルカートリッジ
６０の後部は、分離可能な横断部材６６を有する。この
分離可能な横断部材６６は、発射手段４０のカートリッ
ジ係止手段４７の頂上に配設されている。同時に、２脚
６５がステープルカートリッジを下部片５０に係止す
る。図２で一番よく解るように、これらの脚６５は、下
部片５０のシリンダ５８と第二の位置で係合する。
【００１６】図１では、上部片３０は、後部上部取っ手
部分３１と前部上部ジョー部分３２とを有する。同様
に、下部片５０は、後部可動下部取っ手部分５１と前部
下部ジョー部分５３とを包含する。図１〜１３に示す外
科手術用ステープラー２０の実施例では、発射手段４０
と板バネ５７とステープルカートリッジとを、下部片５
０に組み込んでいる。しかし、これらの要素は、下部片
５０の替わりに上部片３０に配設されてもよい。
【００１７】図１に示す下部取っ手部分５１は可動であ
り、更に詳しく言えば、２係止位置間を旋回可能であ
る。第一の係止位置での可動下部取っ手部分５１は、下
部ジョー部分５３に斜角で配設されている。第一の係止
位置では、下部取っ手５１のＣ字型部材５２は、定置係
止ピン３３からの係合がはずれる。上部および下部片３
０と５０とは、ステープラー２０操作前後に、第一の係
止位置で、それぞれ分離する。一方、第二の係止位置で
は、可動下部取っ手５１のＣ字型部材５２は、上部片３
０と下部片５０とを共に係止する。第二の係止位置で
は、可動下部取っ手部分５１は、下部ジョー部分５３と
平行である。この第二の係止位置は、係止固定ピン３３
がＣ字形部材５２と係合することによって起こる。この
可動取っ手部分の設計は、上部取っ手部分３１上に、あ
るいは下部取っ手部分５１上にあってもよい。
【００１８】発射手段４０は、図２で一番良く解るよう
に、一般的に少なくとも１個の押し出し棒４２から構成
される。図１の発射ノブ５９は、押し出し棒４２を、第
二の位置にある間に、ステープルカートリッジ６０を介
して移動させることによって、発射手段４０を起動す
る。本発明の発射手段４０はまた、蓋状アセンブリ７０
を包含する。
【００１９】蓋状アセンブリ７０の種々の要素を図２に
示す。蓋状アセンブリ７０は、ステープラー２０の前部
近くに狭い蓋状部分７１を有する。この狭い蓋状部分７
１は、広く張り出した蓋状部分７２と共に一体となって
いる。ナイフ用スリット７３が広く張り出した蓋状部分
７２と狭い蓋状部分７１の両方を介して通過している。
広く張り出した蓋状部分７２は、狭い蓋状部分７１より
２本多くスリットを包含する。広く張り出した蓋状部分
７２のこの２本のスリットは、押し出し棒用スリット７
４である。狭い蓋状部分７１の幅は、この２本の押し出
し棒４２間の横断距離より狭い。従って、押し出し棒４
２は、狭い蓋状部分７１周囲を、また狭い蓋状部分を通
過して、ステープルカートリッジ６０の縦方向スロット
６３方向に摺動する。広く張り出した蓋状部分７２の外
側の２本の押し出し棒用スリット７４は、２本の押し出
し棒４２を収納可能である。押し出し棒４２が押し出し
棒用スリット７４を介して摺動するにつれて、ナイフ刃
アセンブリ４４は、前方の第二の位置に移動する。
【００２０】図１に戻る。発射手段４０は、また切断手
段も包含する。詳しく言えば、切断手段はナイフ刃アセ
ンブリ４４である。切断面４５は、ナイフ刃アセンブリ
４４内に包含されている。切断面４５を図１〜８に示
す。一般的に、ナイフ刃アセンブリ４４は、押し出し棒
４２間に配設されている。ナイフ刃アセンブリを図１〜
１３に示しているが、組織を、ナイフあるいはかみそり
刃切断以外の種々の方法で切断してもよい。例えば、レ
ーザあるいは化学的組織破壊あるいは裂断は、使用可能
な数種の切断手段である。これらやその他の組織切断手
段は、本発明の範囲内に含まれると考えられるものであ
る。
【００２１】第一の位置では、ナイフ刃アセンブリ４４
はスロット６４と一直線上に並んでいない。第二の位置
では、ナイフ刃アセンブリ４４は、スロット６４と一直
線上に並んでいる。本外科手術用ステープラーの操作
は、１９９０年１月９日に発行され、公共に譲渡された
米国特許第４，８９２，２４４号（Ｆｏｘ等）に開示さ
れている外科手術用ステープラーと同様である。
【００２２】図２と３と４に示すナイフ刃アセンブリ４
４は、第一の位置に係止されている。第一の位置では、
板バネ５７は、ナイフ刃アセンブリ４４を蓋状部分７０
に押し上げる。これを、図４の矢印で示す。ナイフ刃ア
センブリ４４の上方への力は、広く張り出した蓋状部分
７２を、ナイフ係止手段領域４６に締めつけて動かなく
させる。図３と４とに示すように、板バネ５７の上方へ
の圧力は、蓋状係止部分４８を、広く張り出した蓋状部
分７２の後部より前方には移動できない高さにまで持ち
上げる。ステープラー２０を操作しようとして発射ノブ
５９を前方に押し出した場合でも、このようになる。こ
の第一の位置で、ナイフ刃部品４４は移動不可能であ
る。２本の平行押し出し棒４２も、第一の位置では移動
不可能である。従って、ナイフ刃アセンブリ４４が第一
の位置にある時は、２本の平行押し出し棒４２は、ステ
ープル８０を、充填ステープルカートリッジ６０から無
理に移動させることはできない。
【００２３】ナイフ刃アセンブリ４４が第二の位置に配
置されている時には、充填ステープルカートリッジ６０
が装着される時にカチッという音が聞こえる。ステープ
ルカートリッジ６０は、ステープルカートリッジ６０の
脚６５を、下部片５０のシリンダ５８と係合することに
よって下部片５０上に装着される。図７では、分離可能
横断部材６６がまだそのままの状態である時点を示す。
この時点で、新しいステープルカートリッジ６０は、縦
方向スロット６３内にステープル８０を有する。ステー
プル８０がステープルカートリッジ６０より発射される
前が、この同じ時点であり、図５と６とにこれを示す。
図５と６とに示す分離可能横断部材６６は、カートリッ
ジ係止手段４７上に下方への力を加える。この下方への
力が、ナイフ刃アセンブリ全体４４と、ナイフ刃アセン
ブリ４４の下にある板バネ５７とを押し下げる。このこ
とが起こると、ナイフ刃アセンブリの係止は外れる。従
って、図６で一番良く示されているように、使用者は発
射ノブ５９をステープルカートリッジ６０方向に押すこ
とができる。発射ノブ５９を押すことによって、ナイフ
刃アセンブリ４４を前方に移動させる。ナイフ刃アセン
ブリの係止が外される時に、ナイフ固定手段４６は、も
はや蓋状アセンブリ７０の広く張り出した蓋状部分７２
の下に無理に締め付けられることはなくなる。
【００２４】次に、ナイフ刃アセンブリ４４はステープ
ルカートリッジ６０方向に移動する。ナイフ刃アセンブ
リ４４が移動するにつれて、横断部材分離部分４９は、
分離可能横断部材６６を分離させる。次にナイフ切断面
４５がステープルカートリッジ６０のスロット６４を介
して移動する。２本の押し出し棒４２は、ステープル８
０をステープルカートリッジ６０より同時に押し出す。
分離可能横断部材６６の分離後の段階を図８に示す。ス
テープル点綴操作の完了は、縦方向スロット６３内にス
テープル８０がないことによって判明する。また、分離
可能横断部材６６は永久に分離したままであるので、使
用済のステープルカートリッジ６０′が再使用されるこ
とは実際上ありえない。
【００２５】図４と６とを比較すると、第一の位置（図
４）と第二の位置（図６）とにおけるナイフ刃アセンブ
リ４４の種々の部分の相互作用が判明する。図６は、ス
テープルカートリッジ６０を包含すること以外は、図４
と類似している。例えば、図６では、ステープルカート
リッジ６０の脚６５を仮線で示している。脚６５はシリ
ンダ５８周囲を囲む。分離可能横断部材６６による下方
への力は、第二の位置における板バネ５７による上方へ
の力より大きい。従って、分離可能横断部材６６による
力の結果、蓋状係止部分４８は蓋状アセンブリ７０の高
さより低くなる。従って、蓋状係止部分４８はもはや第
二の位置におけるナイフ刃アセンブリ４４の前方への移
動を阻止しない。
【００２６】前述の実施例の部品と同様の次の実施例の
部品では、参照符号の下２桁は、前述の実施例の対応す
る部品の参照符号と同じになっているが、但し、下２桁
の前に１という数字をつけている。本発明の別の実施例
を図９と１０に示す。
【００２７】図９と１０の実施例は、トグル型ゲートで
ある回転可能部材１６７を有している。回転可能部材１
６７は、第一の後方平行延在面１６２ａに接着してい
る。未使用のステープルカートリッジ１６０は、ナイフ
刃アセンブリ１４４を横断して第二の後方平行延在面１
６２ｂ方向に延出する回転可能部材１６７を有してい
る。第二の位置での回転可能部材１６７は、ナイフ刃ア
センブリ１４４を押さえつけることによって、分離可能
横断部材６６と同様の機能を果たす。回転可能部材１６
７は、第二の位置ではカートリッジ係止手段１４７と係
合することが示されている。回転可能部材がカートリッ
ジ係止手段１４７と係合する時、回転可能部材は板バネ
１５７を押さえつける。板バネが押さえられた後に、ナ
イフ刃アセンブリ１４４はステープルカートリッジ１６
０方向に移動する。
【００２８】図９の矢印は、ナイフ刃アセンブリ１４４
がステープルカートリッジ１６０方向の前方に移動した
時に、回転可能部材１６７が側面に回転する方法を示し
ている。回転可能部材１６７は、第一の位置では、ナイ
フ刃アセンブリ１４４と平行である。これを、図９と１
０の仮線で示す。
【００２９】前述の第一の実施例と同様の部品である次
の実施例でも、参照符号の下２桁は、第一の実施例の対
応する部品の参照符号と同じになっているが、但し下２
桁の前に２という数字をつけている。形成ワイヤ部材２
６８をステープルカートリッジ内に使用している本発明
の更に別の実施例を図１１と１２と１３とに示す。この
実施例ではまた、２本の後方平行延在面２６２ａと２６
２ｂ内に成形されている２個の空洞２６９ａと２６９ｂ
が必要である。
【００３０】図１３では、形成ワイヤ部材２６８が実質
的にカートリッジスロット２６４の全長に沿って、第一
の空洞２６９ａ内に延出していることを示す。次に、形
成ワイヤ部材２６８は第一の後方平行延在面２６２ａに
沿って延出する。そして形成ワイヤ部材２６８はカート
リッジ係止手段２４７の頂面を越えて延在する。その
後、形成ワイヤ部材２６８は、第二の後方平行延在面２
６２ｂに沿って延出する。最後に、形成ワイヤ部材２６
８は、第二の空洞２６９ｂ内に、またそこを出て最終点
まで、第二の後方平行延在面２６２ｂの前面に沿って延
出する。
【００３１】第二の位置におけるこの実施例を図１１に
示す。図１１では、形成ワイヤ部材２６８は、ナイフ刃
アセンブリ２４４の頂面と係合する。形成ワイヤ部材２
６８は、この係合を、カートリッジ係止手段２４７で行
う。図１１の矢印は、ナイフ刃アセンブリ２４４が前方
に移動可能であることを示している。形成ワイヤ部材２
６８がナイフ刃アセンブリ２４４を下方に押しているた
め、ナイフ刃アセンブリ２４４は前方に移動可能であ
る。前述の第一の実施例に関する図４と６との比較は、
現在説明の実施例の図１１と１２の比較に適応する。
【００３２】図１２は、形成ワイヤ部材２６８がカート
リッジ係止手段２４７の頂面を下方に押し下げて保持不
可能な場合の第一の位置での形成ワイヤ部材２６８を示
している。図１３の仮線で示す形成ワイヤ部材２６８′
は、空洞２６９ａと２６９ｂから外れる。その結果、形
成ワイヤ部材は、板バネ２５７の上方への力を相殺する
のに十分な下方への力を、ナイフ刃アセンブリ２４４上
に加えることはできない。従って、未使用のステープル
カートリッジ２６０をステープラー２２０に配設するこ
とが必要となる。つまり、オペレータがステープラー２
２０を、ナイフ刃アセンブリ２４４が可動である第二の
位置に戻すことを所望した場合である。
【００３３】本発明の特徴が独創的な組合せとなってい
るため、これを使用済外科手術用ステープルカートリッ
ジの再発射あるいは再装填を阻止するための外科手術用
ステープラー内使用に適するようにさせている。これ
が、外科医の手術速度を加速し、時間を短縮している。
当然これらの組合せは、他の型のカートリッジ装填式機
械装置に有益である可能性がある。無論、数種類の方法
が実現可能であるが、本発明を図示する上で、特に有利
な実施例を選択した。種々の変更および変形例は、請求
項およびその均等範囲に属するものによって定義される
本発明の範囲を逸脱するものでないことが、当該技術に
熟練せる者によって理解されるであろう。
【００３４】この発明の具体的な実施態様は次のとおり
である。
【００３５】１）前記カートリッジが、前記切断手段と
平行に、また前記カートリッジの最後部より後方に延在
する一対の後方平行延在面を有する請求項１に記載の外
科手術用ステープラー。
【００３６】２）前記カートリッジ上に配設される手段
が、第一の後方延在面に付着し、前記切断手段を横断し
て前記第二の位置内の前記第二の後方延在面方向に延出
しており、また、切断手段と平行となるような第一の位
置に回転可能な回転部材である上記実施態様第１項に記
載の外科手術用ステープラー。
【００３７】３）前記カートリッジ上に配設される手段
が、後方延在第一面の第一の空洞と、後方延在第二面の
第二の空洞とを有するカートリッジ内にある形成ワイヤ
部材であり、前記形成ワイヤは、前記カートリッジスロ
ットの前部近くで始まり、前記スロットの全長に実質的
に沿って配設され、前記カートリッジスロット最後部よ
り外に前記第二の位置に延在しており、前記ワイヤ形状
は、前記切断手段の上面と係合している間は、前記第一
と第二の後方平行延在面の前記第一と第二の空洞内に延
出し、前記第一の位置内の前記形成ワイヤ部材は前記切
断手段の上面と係合せず、前記形成ワイヤ部材は前記第
一と第二の空洞より解放される上記実施態様第１項に記
載の外科手術用ステープラー。
【００３８】４）前記カートリッジ上に配設される手段
が、後方平行延在第一面より第二の位置内の後方平行延
在第二面にまで延出し、第一の位置で分裂する分裂可能
横断部材である上記実施態様第１項に記載の外科手術用
ステープラー。
【００３９】５）前記切断手段がナイフ刃アセンブリで
ある上記実施態様第４項に記載の外科手術用ステープラ
ー。
【００４０】６）前記カートリッジが前記スロットの両
側に隣接する２列のステープルを有する上記実施態様第
５項に記載の外科手術用ステープラー。
【００４１】７）前記ステープラーが、上部取っ手部分
と上部ジョー部分と定置係止ピンとを有する上部片と、
可動下部取っ手部分と下部ジョー部分とを有する下部片
とを有する上記実施態様第６項に記載の外科手術用ステ
ープラー。
【００４２】８）前記可動下部取っ手部分は、前記可動
下部取っ手部分のＣ字型部材が前記定置係止ピンとの係
合をはずれる第一の係止位置と、前記定置係止ピンが前
記可動下部取っ手部分のＣ字型部材と係合する第二の係
止位置間を旋回可能である上記実施態様第７項に記載の
外科手術用ステープラー。
【００４３】９）前記発射手段が、ナイフ刃アセンブリ
と、前記ナイフ刃アセンブリの両側に１本ずつの押し出
し棒と、ナイフ刃アセンブリがそこを介して通過するナ
イフスリットと、押し出し棒が通過するためのナイフス
リット両側の押し出し棒スリットとを有する蓋状アセン
ブリとから構成される上記実施態様第８項に記載の外科
手術用ステープラー。
【図面の簡単な説明】
【図１】本発明の外科手術用ステープラーの分解斜視図
である。
【図２】係止機構の部品が切欠かれた分解斜視図であ
る。
【図３】ステープルカートリッジ挿入前で、切断手段が
係止第一位置にあることを示す部分的に断面である側面
立面図である。
【図４】係止機構が切断手段を第一の位置で係止してい
ることを示す部分的に断面である拡大詳細図である。
【図５】ステープルカートリッジが適所にある状態の図
３と類似の図である。
【図６】ナイフ刃アセンブリが第二の位置にあることを
示す部分的に断面である拡大詳細図である。
【図７】ステープルカートリッジ発射前のナイフ刃アセ
ンブリを示す、図６の線７−７に沿った上部平面図であ
る。
【図８】ステープルとナイフ刃アセンブリ発射後に、分
離手段が本発明の一実施例のカートリッジ上に配設され
ていることを示す図７のアセンブリの上部平面図であ
る。
【図９】本発明の他の実施例の固定機械装置の斜視図で
ある。
【図１０】図９に記載の実施例を示す図７と類似の上部
平面図である。
【図１１】ナイフ刃アセンブリが、ステープルを包含す
るステープルカートリッジのカートリッジスロットを介
して前方に移動している時の、本発明の係止機構の他の
実施例の部分的に断面である側面立面概略図である。
【図１２】ナイフ刃アセンブリが、もはやステープルを
包含していないステープルカートリッジのカートリッジ
スロットを介して後方に移動している時の、図１１の実
施例の部分的に断面である側面立面概略図である。
【図１３】図１１に記載の実施例を示す、図１０と類似
の上部平面図である。
フロントページの続き (72)発明者 ジョン・エイ・シャーマン アメリカ合衆国、45249 オハイオ州、 シンシナティ、ウインスロップ・ドライ ブ 9013 (56)参考文献 米国特許3079606（ＵＳ，Ａ) (58)調査した分野(Int.Cl.7，ＤＢ名) A61B 17/064 - 17/115

Claims (2)

    (57)【特許請求の範囲】
  1. 【請求項１】 前部分と後部分とを有し、隣接する列の
    ステープル間に配設されかつ実質的に前記列の全長に延
    在するカートリッジスロットを有する使い捨てカートリ
    ッジ内に収納される複数本の列のステープルを使用する
    外科手術用ステープラーであって、前記ステープルを発
    射する手段と、前記スロット内を移動可能であり、底
    面、頂面および切断刃を有する切断手段と、前記切断手
    段を前記スロットと一直線上に並ばないような第一の位
    置に配置するために前記ステープラー内に配設され前記
    切断手段の底面と係合しかつ前記切断手段の底面に上方
    への力を加える板バネを有する、前記スロット内の前記
    切断手段の移動を阻止する係止機構と、前記カートリッ
    ジ上に配設されて前記切断手段の頂面と係合し、前記板
    バネを押さえ、前記切断手段を前記第一の位置から前記
    スロットと一直線上に並ぶような第二の位置まで移動さ
    せ、それによって前記切断手段が前記スロット内を移動
    可能となるような手段とを備えたステープラー。
  2. 【請求項２】 隣接するステープルの列間に配設されか
    つ実質的に前記列の全長に延在するカートリッジスロッ
    トを有する使い捨てカートリッジ内に収納される複数本
    の列のステープルを使用しており、前記ステープルを発
    射する手段と、前記スロット内を可動な切断手段とを包
    含する外科手術用ステープラーであって、前記スロット
    内の前記切断手段の移動を阻止する係止機構を備え、前
    記係止機構は前記切断手段と係合可能でありかつ前記切
    断手段を前記スロットと一直線上に並ばないようにする
    ために前記切断手段に上方への力を加える板バネを有す
    るステープラー。
JP33938791A 1990-11-30 1991-11-29 外科手術用ステープラー Expired - Lifetime JP3165206B2 (ja)

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Application Number Priority Date Filing Date Title
US620119 1990-11-30
US07/620,119 US5129570A (en) 1990-11-30 1990-11-30 Surgical stapler

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Publication Number Publication Date
JPH0538341A JPH0538341A (ja) 1993-02-19
JP3165206B2 true JP3165206B2 (ja) 2001-05-14

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EP (1) EP0488768B1 (ja)
JP (1) JP3165206B2 (ja)
AT (1) ATE136757T1 (ja)
AU (1) AU646515B2 (ja)
BR (1) BR9105159A (ja)
CA (1) CA2056557C (ja)
DE (1) DE69118830T2 (ja)
ES (1) ES2085972T3 (ja)
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JPH0538341A (ja) 1993-02-19
CA2056557C (en) 2002-08-27
CA2056557A1 (en) 1992-05-31
AU8820691A (en) 1992-06-04
EP0488768B1 (en) 1996-04-17
DE69118830T2 (de) 1996-09-26
DE69118830D1 (de) 1996-05-23
US5129570A (en) 1992-07-14
US5275323A (en) 1994-01-04
US6131789A (en) 2000-10-17
BR9105159A (pt) 1992-07-21
EP0488768A1 (en) 1992-06-03
ES2085972T3 (es) 1996-06-16
AU646515B2 (en) 1994-02-24
ATE136757T1 (de) 1996-05-15
GR1000992B (el) 1993-03-31
GR910100467A (en) 1992-10-08

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