JP4131476B2 - 内視鏡による縫合システム - Google Patents
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Description
本特許出願は、発明者ノーマン・エス・ゴードンによって1992年9月4日に提出され、「内視鏡による縫合システム」と題された特許出願連続番号第07/941,382号の一部継続出願である。
1)チャンバを有するカニューレ状本体部材を剌創を通じて体腔内に挿入するステップであって、チャンバにはある一定の長さの縫合糸材料の両端に取付けられた第1および第2の針と、針キャッチ装置と、針配備メカニズムとが入れられる。2)針配備メカニズムで、刺創に隣接する体腔壁の第1の領域内に第1の針を延ばし、剌創に隣接する体腔壁の第2の領域内に第2の針を延ばすステップ。3)第1および第2の針を針キャッチ装置内に捕捉するステップ。4)刺創を介して体腔から本体部材を引出し、それによって縫合糸のループを形成し、これを剌創の対向する領域に固定するステップ。
縫合糸92aは、溝94aによって(溝94aは図4Aおよび4Bにおいて隠れてしまっているが、対向する針ガイド58bの溝94bを見ることができる)針ガイド58aから出て、外部ハウジング32内の凹部96の中に保管される。
(1) 体腔の壁におけるトロカールの刺創を取巻く組織を接合するために縫合糸を適用するための外科用縫合装置であって、
ある一定の長さの縫合糸材料の両端に取付けられる第1の針および第2の針と、 針キャッチと、
上記針キャッチ内で終わる第1および第2の経路に沿って上記第1の針および第2の針を動かすための針配備メカニズムと、
体腔の壁における刺創を通じて、上記第1の針、上記第2の針、上記縫合糸材料、上記針キャッチ、および上記針配備メカニズムを体腔内に挿入するためのカニューレ状本体部材とを備え、上記針配備メカニズムは上記針を上記カニューレ状本体部材の外側の領域に移動させ、体腔の壁内に移動させ、上記カニューレ状本体部材に戻すことにより、上記縫合糸のループを形成し、上記縫合糸のループは、上記カニューレ状本体部材が、上記第1の針、上記第2の針、上記縫合糸材料、上記針キャッチ、および上記針配備メカニズムとともに体腔から引抜かれたときに、刺創の両側における組織を接合する、外科用縫合装置。
(2) 上記第1および第2の針を導くための第1および第2の針ガイドをさらに含む、項(1)に記載の外科用縫合装置。
(3) 上記第1および第2の針を保持するための第1および第2の針キャリアをさらに含む、項(2)に記載の外科用縫合装置。
(4) 上記針キャリアおよび針ガイドは、実質的に半円形状を有する、項(3)に記載の外科用縫合装置。
(5) 上記第1の針を上記第1の針ガイドに押し通すための第1の可撓性円筒形部材をさらに含む、項(2)に記載の外科用縫合装置。
(6) 縫合糸取付点を有する第1の針と、
縫合糸取付点を有する第2の針と、
上記第1の針の縫合糸取付点に取付けられた第1の端、および上記第2の針の縫合糸取付点に取付けられた第2の端を有する縫合糸と、
上記第1および第2の針を受取り、保持するための捕捉システムと、
a)最初は上記捕捉システムから離れるように逸れ、次いで上記捕捉システムに向かって集約される第1の経路に沿って、上記第1の針を動かし、b)最初は上記捕捉システムから離れるように逸れ、次いで上記捕捉システムに向かって集約される第2の経路に沿って、上記第2の針を動かすための、針配備システムと、 上記第1および第2の針、上記縫合糸、上記針配備システム、ならびに上記捕捉システムを入れるためのチャンバを有する、カニューレ状本体部材とを含む、縫合装置。
(7) 上記第1および第2の経路に沿って上記第1および第2の針を導くための第1および第2の針ガイドをさらに含む、項(6)に記載の縫合装置。
(8) 上記第1および第2の針を保持するための、第1および第2の針キャリアをさらに含む、項(6)に記載の縫合装置。
(9) 上記針ガイドは、実質的に半円形状である、項(7)に記載の縫合装置。
(10) 上記第1の針ガイドに上記第1の針を押し通すための、第1の細長い可撓性部材をさらに含む、項(7)に記載の縫合装置。
(11) 管状本体部材内に含まれるある一定の長さの縫合糸材料の両端に取付けられた第1の針および第2の針と、
上記管状本体部材内に含まれ、上記本体部材の外にある領域をわたって上記本体部材上のキャッチメカニズムに戻る第1および第2の経路に沿って上記第1および第2の針を動かすための、針配備メカニズムとを含む、縫合装置。
(12)上記第1および第2の針によってわたられる上記第1およひ第2の経路の形状を規定する、第1および第2の針ガイドをさらに含む、項(11)に記載の縫合装置。
(13) 上記第1および第2の針を保持するための、第1および第2の針キャリアをさらに含む、項(11)に記載の縫合装置。
(14) 上記針ガイドは、実質的に半円形状である、項(12)に記載の縫合装置。
(15) 上記第1の針ガイドに上記第1の針を押し通すための、第1の細長い可撓性部材をさらに含む、項(12)に記載の縫合装置。
(16) 縫合糸に取付けられた針と、
最初は基準面の片側を遮断し、面を通過し、方向を逆転させ、その後面の反対側を遮断する経路に沿って、上記針を移動させる針配備メカニズムとを含む、縫合適用装置。
(17) 上記経路に沿って上記針を導くための、針ガイドをさらに含む、項(16)に記載の縫合装置。
(18) 上記針を保持するための針キャリアをさらに含む、項(16)に記載の縫合装置。
(19) 上記針ガイドは、実質的に半円形状である、項(17)に記載の縫合装置。
(20) 上記針を上記経路に沿って押すための第1の細長い可撓性部材をさらに含む、項(16)に記載の縫合装置。
(21) 上記縫合糸に取付けられた第2の針をさらに含む、項(16)に記載の縫合装置。
(22) 体腔の壁におけるトロカールの刺創を接合する方法であって、
上記刺創を通じて上記体腔内にチャンバを有するカニューレ状本体部材を挿入するステップを含み、上記チャンバには、ある一定の長さの縫合糸材料の両端に取付けられた第1の針および第2の針、針捕捉装置、ならびに針配備メカニズムが入っており、さらに
上記針配備メカニズムで、上記刺創に隣接する体腔の上記壁における第1の領域内に上記第1の針を延ばし、上記刺創に隣接する体腔の上記壁における第2の領域内に上記第2の針を延ばすステップと、
上記針捕捉装置内に上記第1および第2の針を捕捉するステップと、
上記刺創を介して上記体腔から上記本体部材を引抜き、それにより上記縫合糸のループを形成し、これを上記刺創における対向する領域に固定するステップとを含む、体腔の壁におけるトロカールの刺創を接合する方法。
(23) 上記配備メカニズムを、上記カニューレ状本体部材の上記チャンバ内に戻るように引込めるステップをさらに含む、項(22)に記載の方法。
(24) 内部チャンバを規定する細長いカニューレ状本体部材と、
上記カニューレ状本体部材の基部の端付近に位置付けられ、上記内部チャンバ内に延びる、第1のアクチュエータとを含み、上記第1のアクチュエータは引込められた位置および配備された位置を有し、さらに
上記細長いカニューレ状本体部材の末端部の端付近にある上記内部チャンバ内に旋回するように装着される針キャリアを含む第1の針配備メカニズムを含み、上記第1の針配備メカニズムは上記第1のアクチュエータに接続され、かつ、上記第1の針配備メカニズムが実質的にすべて上記内部チャンバ内に入っている上記引込められた位置に上記第1のアクチュエータがある時には引込められた形態を有し、上記配備された位置に上記第1のアクチュエータがあるときには配備された形態を有し、上記配備された位置においては、上記第1のアクチュエータが上記引込められた位置から上記配備された位置に向かって動き始める際の上記カニューレ状本体部材から離れる最初の方向と、それに続く上記第1のアクチュエータが上記配備された位置に接近する際の上記カニューレ状本体に向かう方向とを、有する経路に沿って、上記内部チャンバの外へ上記針キャリアを上記第1の針配備メカニズムが移動させる、縫合装置。
(25) 上記針キャリア内に挿入される縫合糸取付点を有する針と、
上記針の縫合糸取付点に取付けられる縫合糸と、上記針キャリア経路における上記カニューレ状本体部材に向かって接近する上記部分を遮断する位置にある上記カニューレ状本体部材上に位置付けられる針捕捉システムとをさらに含む、項(24)に記載の縫合装置。
(26) 上記第1のアクチュエータおよび上記第1の針配備メカニズムからは独立的に配備可能である、第2のアクチュエータおよび第2の針配備メカニズムをさらに含む、項(24)に記載の縫合装置。
(27) 上記第1のアクチュエータによって上記第1の針配備メカニズムと同時に配備可能である第2の針配備メカニズムを含み、上記第1および第2の針配備メカニズムは上記カニューレ状本体部材の両側に配備される、項(24)に記載の縫合装置。
(28) 上記第1のアクチュエータは、第1のサブアクチュエータと第2のサブアクチュエータとを含み、その各々は互いに独立している引込められた位置と配備された位置とを有し、上記第1の針配備メカニズムは、上記第1のサブアクチュエータが上記引込められた位置から上記配備された位置に向かって動く際の上記カニューレ状本体部材から離れる最初の方向と、それに続く上記第2のサブアクチュエータが上記引込められた位置から上記配備された位置に向かって動く際の上記カニューレ状本体部材に向かう方向とを有する上記経路に沿って上記内部チャンバの外へ上記針キャリアを移動させる、項(24)に記載の縫合装置。(29) 限られた空間内の位置において縫合糸を固定するための縫合装置であって、
カートリッジを含み、上記カートリッジはさらに、
取付点を有するカートリッジ本体部材と、
上記カートリッジ本体部材上に装着されるある一定の長さの縫合糸材料の両端に取付けられる第1の針および第2の針とを含み、上記装置はさらに、
アプリケータツールを含み、上記アプリケータツールはさらに、
内部の空洞を規定するアプリケータツール本体部材を含み、上記アプリケータツール本体部材は上記カートリッジ本体部材の取付点とつながる取付点を含み、さらに
上記アプリケータツール本体部材の内部の空洞内に含まれる針配備メカニズムを含み、上記針配備メカニズムは上記第1および第2の針を保持し、かつ上記第1および第2の針が上記本体部材の内部の空洞内に含まれている第1の位置、ならびに上記第1および第2の針が上記本体部材の内部の空洞の外に位置している第2の位置を有する、縫合装置。
(30) 上記針配備メカニズムは、上記第1および第2の針を保持するための第1および第2の針キャリアをさらに含む、項(29)に記載の縫合装置。
(31) 上記第1および第2の針キャリアは、実質的に半円形状である、項(30)に記載の縫合装置。
(32) 末端部の端、先の尖った基部の端、および上記末端部の端と上記先の尖った基部の端との中間に位置付けられる肩を有する実質的に断面積が均一な細長い本体部分を含む、手術用針であって、上記肩は上記本体部分の断面積における突然の変化によって規定されており、上記本体部分と上記肩との間の遷移は、上記細長い本体部分の長手方向軸線に対し実質的に垂直な面を規定する、手術用針。
(33) 上記細長い本体部分は、実質的に形状が円錐形である断面を有する、項(32)に記載の手術用針。
(34) 上記細長い本体部分は、実質的に形状が四角形である断面を有する、項(32)に記載の手術用針。
(35) 上記細長い本体部分は、実質的に形状が三角形である断面を有する、項(32)に記載の手術用針。
(36) 上記本体部分の末端部の端に縫合糸を取付けるための手段をさらに含む、項(32)に記載の手術用針。
(37) 上記本体部分の末端部の端に縫合糸を取付るための上記手段は、上記本体部分内に形成されるアイをさらに含む、項(36)に記載の手術用針。
(38) 縫合アプリケータとともに用いるための縫合糸カートリッジであって、 針と、
上記針に取付けられる縫合糸と、
それに対して予め定められた形態に上記針および縫合糸を保持する支持部とを含み、上記支持部はさらに、縫合アプリケータに上記縫合糸カートリッジを取付けるための手段を含む、縫合糸カートリッジ。
(39) 上記カートリッジを予め定められた形態に縫合アプリケータと整列させる、整列要素をさらに含む、項(38)に記載の縫合糸カートリッジ。
(40) 上記針を縫合アプリケータ内に装填するための針ローダをさらに含み、上記ローダは、針ポケットと、上記ポケット内に針を保持する針保持器とを有する本体部材を含み、上記ローダの本体部材はさらに、縫合アプリケータに対して針を予め定められた形態に位置決めする整列特性を含む、項(38)に記載の縫合糸カートリッジ。
(41) 手術用針を縫合ツール内に装填するための針装填装置であって、上記装填装置は針ポケットと上記ポケット内に針を保持する針保持器とを有する本体部材を含み、上記装填装置の本体部材はさらに、針を縫合ツールに対して予め定められた形態に位置決めする整列特性を含む、針装填装置。
(42) 縫合糸カートリッジを備え、上記縫合糸カートリッジは、
針と、
上記針に取付られる縫合糸と、
上記針および縫合糸をそれに対して予め定められた形態に保持する支持部とを含み、上記支持部はさらに工具取付具を含み、
さらに、
アプリケータツールを備え、上記アプリケータツールはさらに、
内部キャビティを規定するアプリケータ本体部材を含み、上記アプリケータ本体部材は、上記カートリッジ支持部の工具取付具と組合せられて、上記縫合糸カートリッジを上記アプリケータツールに装着する、取付具を含み、さらに
上記アプリケータ本体部材の内部キャビティ内に含まれる針配備メカニズムを含み、上記メカニズムは上記針が上記本体部材の内部キャビティ内に含まれる第1の位置と、上記針が上記本体部材の内部キャビティの外に位置している第2の位置とを有する、縫合装置。
(43) 針ポケットおよび上記針ポケット内に上記針を保持する針保持器を有する本体部材を含む、針ローダをさらに備え、上記針ローダの本体部材はさらに、針を上記針配備メカニズムに対して予め定められた形態に位置決めする整列特性を含む、項(42)に記載の縫合装置。
(44) 先細にされた部分によって肩に接続される先端を含む針を備え、上記先細にされた部分と上記肩との接続は上記肩の第1の断面における横方向の寸法を規定し、上記肩はさらに上記先細にされた部分と上記肩との上記接続に直に隣接する上記針の末端部に接続されており、上記末端部の上記肩への接続は、上記肩の上記第1の断面における横方向の寸法よりも小さく、それにより肩の棚状突起を形成する、上記肩の第2の断面における横方向の寸法を規定し、さらに、
上記針の上記末端部に取付けられる縫合糸と、
第1の弛緩した寸法を有する可撓性アパチャを含む針キャッチとを備え、上記第1の弛緩した寸法は上記肩の上記第1の断面における横方向寸法よりも小さいが、上記先細にされた部分が通過することにより上記肩の上記第1の断面における横方向寸法と実質的に等しい引伸ばされた寸法まで上記可撓性アパチャの第1の弛緩した寸法を引伸ばすことにより挿入方向に沿って上記針が上記アパチャ内に挿入されることを許容するものであり、上記アパチャはやはり上記肩の上記第1の断面における横方向寸法よりも小さい第2の弛緩した寸法に戻り、上記肩の棚状突起はそれにより、上記挿入方向の逆である方向において上記キャッチから上記針が取除かれることを回避する、縫合装置。
(45) 上記針キャッチはさらに、上記可撓性アパチャと隣接する除去アパチャを含み、上記除去アパチャは上記肩の上記第1の断面における横方向寸法よりも大きい寸法を有しており、それにより上記針が上記可撓性アパチャから上記除去アパチャに動かされたときに、上記針キャッチから上記針が取除かれることが許容される、項(44)に記載の縫合装置。
(46) 肩をつけられた手術用針を受取り、保持するための受容的針キャッチであって、上記キャッチは可撓性アパチャを含み、上記可撓性アパチャは針の肩が上記可撓性アパチャに送られることを許容するために延び、肩の針が上記可撓性アパチャを通過した後で縮む、受容的針キャッチ。
(47) 上記可撓性アパチャと隣接する除去アパチャをさらに含み、上記除去アパチャは針の肩よりも大きい寸法を有しており、それにより針が上記可撓性アパチャから上記除去アパチャに動かされると上記針キャッチから針が取除かれることが許容される、項(46)に記載の受容的針キヤッチ。
(48) 肩を付けられた手術用針のための受容的針キャッチであって、上記キャッチは少なくとも針の肩と同じくらい大きい寸法を有する第1の領域を有するアパチャを含み、それにより肩が上記アパチャを通過することが許容され、上記キャッチはさらに、針の肩よりも小さい寸法を有する第2の領域を有し、それにより肩が上記アパチャを通過することが阻止される、受容的針キャッチ。
Claims (16)
- 縫合器具であって、
実質的に直線の針挿入装置であって、該針挿入装置は、長手方向軸、基部の端、および末端部の端を有し、該針挿入装置の該末端部の端は、側方出口ポートを規定し、該針挿入装置の該長手方向軸に対して実質的に固定されている、針挿入装置;
該針挿入装置の該末端部の端の内部に配置された、第1の針;ならびに
該針導入装置の該末端部の端の内部に配置された、針配備装置であって、該針配備装置は、該第1の針を、該針挿入装置からほぼ外に、該側方出口ポートを通して組織内へ、そして該針挿入装置の該長手方向軸の方へと駆動する、針配備装置、
を備える、縫合器具。 - 前記針挿入装置の前記末端部の端の内部に配置された、第2の針をさらに備え、該第2の針は、前記針配備装置によって、該針挿入装置からほぼ外に、組織内へ、そして該針挿入装置の前記長手方向軸の方へと駆動される、請求項1に記載の縫合器具。
- 前記第2の針は、前記長手方向軸に対して、前記第1の針と反対方向に、前記針挿入装置から外向きに駆動される、請求項2に記載の縫合器具。
- 前記第1の針の少なくとも一部を受容するように構成された、針キャッチをさらに備える、請求項1に記載の縫合器具。
- 前記第2の針の少なくとも一部を受容するように構成された、針キャッチをさらに備える、請求項2に記載の縫合器具。
- 前記第1の針の末端部の端に取り付けられた縫合糸をさらに備える、請求項1に記載の縫合器具。
- 前記第1の針の末端部の端および前記第2の針の末端部の端に取り付けられた縫合糸をさらに備える、請求項2に記載の縫合器具。
- 前記針キャッチは、該針キャッチの引き抜きが、前記縫合糸を壁に通して引き、該壁においてほぼ対向する縫合位置を通る縫合糸ループを形成するように構成されている、請求項7に記載の縫合器具。
- 身体脈管の壁の開口部を縫合するためのシステムであって、該システムは、
その長手方向の軸に対して実質的に固定されているシャフトの末端部であって、該末端部は、外側組織層の開口部に通し、そして該壁の該開口部に通して挿入されるように構成されており、該シャフトは、実質的に直線の外部ハウジングに含まれている、シャフト;
該シャフトを通して該身体脈管内へと挿入されるように構成されている、第1の針;および
該第1の針を、該シャフトの該長手方向軸に対してほぼ外に配備するための手段、
を備え;
該第1の針は、該壁を通って移動して、該第1の針の少なくとも一部が針キャッチ内に捕捉されるように構成されている、システム。 - 前記針キャッチが引き抜かれるように構成されている、請求項9に記載のシステム。
- 前記針キャッチが、前記外側組織層の前記開口部に通して引き抜かれるように構成されている、請求項10に記載のシステム。
- 前記シャフトを通して体腔に挿入されるように構成されている第2の針をさらに備える、請求項9に記載のシステム。
- 前記第2の針が、前記シャフトの前記長手方向軸に対してほぼ外向きに配備され、そして前記壁を通して移動させられ、これによって、該第2の針の少なくとも一部が前記針キャッチ内に捕捉されるように構成されている、請求項12に記載のシステム。
- 前記針キャッチの内部に前記第2の針が捕捉された状態で、該針キャッチが、前記壁を通して引き抜かれるように構成されている、請求項13に記載のシステム。
- 前記針キャッチが、前記外側組織層の前記開口部を通して引かれるように構成されている、請求項14に記載のシステム。
- 前記第1の針および前記第2の針の引き抜きの構成が、前記体腔の前記壁の前記開口部のほぼ対向する部分を通る、縫合糸材料のループを形成する、請求項14に記載のシステム。
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US07/941,382 US5364408A (en) | 1992-09-04 | 1992-09-04 | Endoscopic suture system |
US08/057,699 US5458609A (en) | 1992-09-04 | 1993-05-04 | Surgical needle and retainer system |
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JP2005185795A Expired - Lifetime JP4131476B2 (ja) | 1992-09-04 | 2005-06-24 | 内視鏡による縫合システム |
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AU (1) | AU673692B2 (ja) |
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-
1992
- 1992-09-04 US US07/941,382 patent/US5364408A/en not_active Expired - Lifetime
-
1993
- 1993-08-17 EP EP94908849A patent/EP0738127B1/en not_active Expired - Lifetime
- 1993-08-17 AU AU50178/93A patent/AU673692B2/en not_active Expired
- 1993-08-17 DE DE69333383T patent/DE69333383T2/de not_active Expired - Lifetime
- 1993-08-17 CA CA002142965A patent/CA2142965C/en not_active Expired - Lifetime
- 1993-08-17 JP JP50722394A patent/JP3380552B2/ja not_active Expired - Lifetime
- 1993-08-17 WO PCT/US1993/007745 patent/WO1994005213A1/en active IP Right Grant
-
1994
- 1994-11-14 US US08/338,247 patent/US5575800A/en not_active Expired - Lifetime
-
1995
- 1995-05-18 US US08/444,207 patent/US5662664A/en not_active Expired - Lifetime
- 1995-09-27 US US08/534,501 patent/US5700272A/en not_active Expired - Lifetime
-
2001
- 2001-10-17 JP JP2001319905A patent/JP2003093394A/ja not_active Withdrawn
-
2005
- 2005-06-24 JP JP2005185795A patent/JP4131476B2/ja not_active Expired - Lifetime
-
2007
- 2007-11-14 JP JP2007296155A patent/JP2008100090A/ja not_active Withdrawn
Also Published As
Publication number | Publication date |
---|---|
JP2003093394A (ja) | 2003-04-02 |
DE69333383T2 (de) | 2004-11-11 |
CA2142965C (en) | 2003-12-09 |
US5575800A (en) | 1996-11-19 |
JPH08501005A (ja) | 1996-02-06 |
US5364408A (en) | 1994-11-15 |
WO1994005213A1 (en) | 1994-03-17 |
AU5017893A (en) | 1994-03-29 |
US5662664A (en) | 1997-09-02 |
EP0738127A1 (en) | 1996-10-23 |
JP2008100090A (ja) | 2008-05-01 |
JP3380552B2 (ja) | 2003-02-24 |
US5700272A (en) | 1997-12-23 |
CA2142965A1 (en) | 1994-03-17 |
EP0738127A4 (en) | 1996-08-28 |
AU673692B2 (en) | 1996-11-21 |
DE69333383D1 (de) | 2004-02-19 |
EP0738127B1 (en) | 2004-01-14 |
JP2005334664A (ja) | 2005-12-08 |
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