JP4190983B2 - ステープル装置 - Google Patents
ステープル装置 Download PDFInfo
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- JP4190983B2 JP4190983B2 JP2003312981A JP2003312981A JP4190983B2 JP 4190983 B2 JP4190983 B2 JP 4190983B2 JP 2003312981 A JP2003312981 A JP 2003312981A JP 2003312981 A JP2003312981 A JP 2003312981A JP 4190983 B2 JP4190983 B2 JP 4190983B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2923—Toothed members, e.g. rack and pinion
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Description
そして、ステープル打ち出しレバー27を操作すると、筒状の挿入部2の内部に収納されたカムバー21がカートリッジ背面のスロットをカートリッジ先端方向へと移動し、カムバー21の先端がステープル保持部材10に当接し、ステープル保持部材10がアンビル6方向へと押され、ステープル7が打ち出され、その後カッターがカートリッジ表面及びアンビル6の表面に設けられたスロットをスライドしていく。すると、ステープリングされた生体組織44が切除される。図7に、カムバー21がスロット内を移動し、ステープル保持部材10をアンビル6方向に押し出している断面拡大図を示す。
ステープル打ち出しレバー27を放すと、ステープル打ち出しレバー27近辺に設けられた巻きバネの力によって、カムバー21及びナイフ20はスロットをスライドし、初期位置に戻る。その後、操作部背面に設けられたリリースボタン42を押すと、ジョー部は全開状態となる。
するとスロット内をスライドするカムバーにそのテンションが作用し、ステープル打ち出しレバー近辺に設けられた巻きバネの力よりテンションによる力が大きくなった場合、カムバー及びステープル打ち出しレバーが元の位置に戻らないといった問題があった。
また、ステープルのテンションに負けないだけの巻きバネを用いると、ステープル打ち出しのための力が大きくなってしまうという問題もあった。
この発明に係るステープル装置は、ジョー開閉手段は、アンビルに連結されたクロージングパイプと、クロージングパイプに連結されたクロージングレバーを備えたものである。
この発明に係るステープル装置は、プレリリースボタンが、ジョー部が全閉状態のみ本体から突出し、操作可能なものである。
この発明に係るステープル装置は、本体部分に軸止された前記プレリリースボタンの端部が描く円弧軌道に対して、第1のカム面端部の段差の角度が円弧軌道の接線よりも内側に傾斜しているものである。
この発明に係るステープル装置は、ロック機構が、中空のプレリリースボタン内部に設けられたロックレバーと、前記ロックレバーの先端に係合する溝を有するカムバーラックと、ロックレバーの一端を前記溝方向に付勢するバネを備えたものである。
この発明に係るステープル装置は、ステープル押し出し手段及びナイフ操作手段は、操作部からジョー部方向に向かって伸びるカムバー及びナイフと、カートリッジ内のステープル収納部近辺に設けられたステープル保持部と、ラック部材を介しカムバー及びナイフと連結されたステープル打ち出しレバーを備えたものである。
図1は、この発明の実施の形態1に係るステープル装置の全体斜視図である。図2は、ジョー部が全開状態を示す断面図である。
このステープル装置1は、体内に挿入される細長い挿入部2と、挿入部2の基端部に連結されガングリップ型をした操作部を有する本体部分3とから構成されている。
挿入部2には先端に向けて徐々に断面積が大きくなるパイプ状のクロージングパイプ4が設けられている。さらに、挿入部2の先端部には体内組織を挾持する開閉自在のジョー部が設けられている。このジョー部にはカートリッジ5とこのカートリッジ5に対して開閉可能に連結されたアンビル6とが設けられている。
カートリッジ5の前部側には図7に示すように生体適合性金属材料からなる略U字状の複数のステープル7が両端部をアンビル6へ向けて放出自在な状態で複数列状に収容するステープル収容部8が形成されている。このカートリッジ5のステープル収容部8に収容されるステープル7の列は複数の列からなり、本実施の形態においては図6に示すように4列形成されている。
クロージングレバー40は、第1及び第2のカム面を備えたカム部とほぼその反対方向に突出した操作部から構成されている。第1及び第2のカム面は軸方向にそれぞれ異なる形状で並んでいる。第1のカム面は、プレリリースボタン41と係合可能なカム面で、もう一方の第2のカム面は、リリースボタン42と係合可能なカム面を有している。図10は、この発明の実施の形態1に係るステープル装置の第1のカム面とプレリリースボタン41の係合部の断面拡大図である。プレリリースボタン41と係合可能なカム面は、図に示すように円弧状に切り欠いた部分から軸方向に鋭角な断部が設けられている。
ケーシング28にはグリップ46が設けられ、グリップ46、クロージングレバー40のレバー部、ステープル打ち出しレバー27のレバー部の順に本体部分3から挿入部2方向に並んでいる。
図3の状態で、ジョー部が患部の切除位置にあることを確認すると、ステープル打ち出しレバー27の操作部をグリップ46方向へと操作する。ステープル打ち出しレバー27の歯がファイアリングラック26の一端に設けられた歯と係合し、ファイアリングラック26が挿入部方向へと移動する。するとファイアリングラック26の他端に設けられた歯が歯車25の小歯車部とかみ合い、歯車25が回転する。歯車25の外周に設けられた大歯車部とカムバーラック24の歯がかみ合い、カムバーラック24は挿入部方向へと移動する。
カムバー21がカートリッジ5内のカムバースロットを移動し、カムバー21の先端がステープル保持部材10の下部をアンビル6方向へと押し出すことにより、ステープル7がアンビル6の表面に設けられた溝と当接し、ステープリングされる。操作部方向から先端部方向に並んだステープル7が、カムバー21の先端が通過する順にステープリングされ、その後にナイフ20のエッジ部がアンビル6に設けられた溝を通過することにより、生体組織44が切離される。
図4において、ステープリングを終えた後、ステープル打ち出しレバー27を開放し初期状態に戻そうとしても、金属などでできている弾性有するステープルは円弧状の部分があるため、ステープル自体がバネとなり、カートリッジ5内のステープル保持部材10とアンビル6の間にテンションがかかる。するとステープルカートリッジ内のスロットをスライドするカムバー21にそのテンションが作用し、ステープル打ち出しレバー近辺に設けられた巻きバネの力よりテンションによる力が大きくなった場合、カムバー21及びステープル打ち出しレバー27が初期位置に戻らなくなる。
なお、本明細書及び請求の範囲において、半開状態という文言を用いたが、生体組織をステープリングした際にカムバー及びステープル打ち出しレバーが確実に初期状態に戻るジョー部の開度であれば良いのであって、たとえばジョー部が全閉より少々開いた微開状態も含むものである。
ロックレバー43は、前述したようにプレリリースボタン41及びリリースボタン42と同軸に設けられて、空洞部を有するプレリリースボタン内で回転出来るようになっている。また、ロックレバー43は板バネにより常にファイアリングラック方向に、押しつけられているので、ステープル打ち出しレバー操作後にプレリリースボタン41を操作した時に後退してきたファイアリングラック26の溝に確実にロックレバー43の端部がはまり込むようになっている。即ち、ジョー部が全閉状態でなければ、ステープル打ち出しレバー27を操作出来ない構造となっている。
図1及び図5の状態で、リリースボタン42を押すと、ジョー部が全開状態となり、ジョー部と生体組織44が完全に離れ、身体内から挿入部を抜くことができる。
また、本実施の形態1によれば、リリースボタンは、ジョー部が半開状態のみ本体から突出し、操作可能であるので、使用者による誤った操作を防止することができる。
また、本実施の形態1によれば、本体部分に軸止されたプレリリースボタンの端部が描く円弧軌道に対して、第1のカム面端部の段差の角度が円弧軌道の接線よりも内側に傾斜しているので、ジョー部が全閉状態なると、プレリリースボタンの端部が段差の内側を強く打ち付け、クリック音を発生させると共に、全閉状態になったことを感覚的にわかりやすくすることができる。
また、本実施の形態1によれば、ジョー部が全閉状態の時のみ、ナイフ操作手段及びステープル押し出し手段を操作可能とするロック機構を設けたので、使用者による誤った操作を防止することができる。
また、本実施の形態1によれば、中空のプレリリースボタン内部に設けられたロックレバーと、ロックレバーの先端に係合する溝を有するファイアリングラックと、ロックレバーの一端を溝方向に付勢するバネを有するロック機構を備えているので、ロックレバーの先端が確実にファイアリングラックの溝に係合し、ロック機構の不具合を防止するものである。
3 本体部分
4 クロージングパイプ
5 カートリッジ
6 アンビル
7 ステープル
10 ステープル保持部材
15 溝
20 ナイフ
21 カムバー
23 カムバーアダプタ
24 カムバーラック
25 歯車
26 ファイアリングラック
27 ステープル打ち出しレバー
28 ケーシング
32 スライダ
40 クロージングレバー
41 プレリリースボタン
42 リリースボタン
43 ロックレバー
Claims (8)
- 操作部を有する本体部分と、前記本体部分から長手方向に伸びる挿入部と、挿入部の先端に設けられた開閉可能なジョー部と、前記ジョー部を開閉するジョー開閉手段と、ステープル押し出し手段と、前記ジョー開閉手段を操作しジョー部を全閉状態から半開状態で保持するプレリリース手段とを備え、
前記ジョー部は、ステープルを収納するカートリッジと、前記カートリッジを保持するカートリッジホルダと、カートリッジホルダに回動自在に設けられたアンビルとを備え、
前記プレリリース手段は、前記アンビルと連動する第1のカム面及び第2のカム面を有したクロージングレバーと、前記第1のカム面と端部が係合するプレリリースボタンと、前記第2のカム面と端部が係合するリリースボタンと、を備えたステープル装置。 - 前記ジョー開閉手段は、前記アンビルに連結されたクロージングパイプを備えたことを特徴とする請求項1記載のステープル装置。
- 前記プレリリースボタンは、ジョー部が全閉状態においてのみ本体から突出し、操作可能であることを特徴とする請求項1記載のステープル装置。
- 前記リリースボタンは、ジョー部が半開状態においてのみ本体から突出し、操作可能であることを特徴とする請求項3記載のステープル装置。
- 前記本体部分に軸止された前記プレリリースボタンの端部が描く円弧軌道に対して、前記第1のカム面端部の段差の角度が円弧軌道の接線よりも内側に傾斜していることを特徴とする請求項1から4のうちのいずれか1項記載のステープル装置。
- 挿入部に設けられたナイフを操作するナイフ操作手段を更に備え、前記ジョー部が全閉状態の時のみ、前記ナイフ操作手段及び前記ステープル押し出し手段を操作可能とするロック機構を備えたことを特徴とする請求項1から5のうちのいずれか1項記載のステープル装置。
- 前記プレリリースボタンの一部は空洞となっており、前記ロック機構は、前記プレリリースボタンの前記空洞に設けられたロックレバーと、前記ロックレバーの先端に係合する溝を有するカムバーラックと、ロックレバーの先端を前記溝方向に付勢するバネを備えたことを特徴とする請求項6項記載のステープル装置。
- 前記ステープル押し出し手段は、操作部からジョー部方向に向かって伸びるカムバーと、カートリッジ内のステープル収納部近辺に設けられたステープル保持部と、ラック部材を介しカムバーと連結されたステープル打ち出しレバーを備えたことを特徴とする請求項1から7のうちのいずれか1項記載のステープル装置。
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| Application Number | Priority Date | Filing Date | Title |
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| JP2003312981A JP4190983B2 (ja) | 2003-09-04 | 2003-09-04 | ステープル装置 |
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| JP2003312981A JP4190983B2 (ja) | 2003-09-04 | 2003-09-04 | ステープル装置 |
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| Publication Number | Publication Date |
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| JP2005080702A JP2005080702A (ja) | 2005-03-31 |
| JP4190983B2 true JP4190983B2 (ja) | 2008-12-03 |
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| JP2003312981A Expired - Fee Related JP4190983B2 (ja) | 2003-09-04 | 2003-09-04 | ステープル装置 |
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-
2003
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