JP4565218B2 - 単一挿管複数回縫合内視鏡型縫合システム - Google Patents
単一挿管複数回縫合内視鏡型縫合システム Download PDFInfo
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- JP4565218B2 JP4565218B2 JP2006533214A JP2006533214A JP4565218B2 JP 4565218 B2 JP4565218 B2 JP 4565218B2 JP 2006533214 A JP2006533214 A JP 2006533214A JP 2006533214 A JP2006533214 A JP 2006533214A JP 4565218 B2 JP4565218 B2 JP 4565218B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0467—Instruments for cutting sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00818—Treatment of the gastro-intestinal system
- A61B2017/00827—Treatment of gastro-esophageal reflux
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0448—Additional elements on or within the anchor
- A61B2017/045—Additional elements on or within the anchor snug fit within the anchor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/047—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery having at least one proximally pointing needle located at the distal end of the instrument, e.g. for suturing trocar puncture wounds starting from inside the body
Description
図4の縫合カプセルは縫合カプセル100の透視斜視図である。縫合カプセル100は、施術中の体内組織への外傷の可能性を減少させる非外傷性形状を有する円筒状本体102を含む。カプセルは構成と動作において前述の米国特許第5,792,153号にて開示されたものと同様である。カプセルは吸引チャンバ106へ開いた吸引ポート104を含み、吸引チャンバへチャンバ内に導入された真空により縫合しようとする組織部分が捕集される。カプセルは針108を含み、針はカプセルを貫通して形成されている針トラック110を通って摺動可能である。針は下腿ステンレススチール製のシャフト部分と鋭利な先端部分112からなり基端でプッシャーシャフト184に接合されており、シャフトが縫合カプセルから基端側へ内視鏡の作業チャネルを介して延在する。プッシャーシャフトは内視鏡の基端から延出し、ここで後述する制御ハンドルに接合され操作されるようになっている。針を長手方向に針トラックを通って移動させると、吸引チャンバ106を横断し、チャンバ内に吸引された組織が先端方向へ前進する針によって穿孔される。
好適な縫合糸制御ハンドル200の側面図を図16に示す。
本発明にかかる縫合糸ロック及び縫合糸ロック供給装置は結び目を結紮する厄介な作業を回避する縫合糸を固定するためのメカニズムを提供することによりシステムの有用性に寄与し、内視鏡の作業チャネルを通して供給することができる機械的縫合糸リテーナを提供することで処置を完了するために別の器具を再挿管する必要性を無くしている。本明細書に記載される縫合糸ロックと供給装置はPCT公開番号WO01/89393号に対応して保留中の米国特許出願第10/275,534号に開示されたものと類似する。当該米国特許出願の全体が参照により本明細書に含まれる。
前述した単一回挿管縫合システムの動作について、図55から図63に提示した図面との関連で、図39から図54に図示した略図を参照して説明する。装置の動作において、縫合カプセル100は最初に図39に図示したように内視鏡10の先端に装着される。針108と縫合糸タグ114を吸引チャンバ106より基端側に配置して、カプセル内視鏡アセンブリを自然の体腔を通して意図している組織部分まで前進させる。この状態が図55にも図示してある。
Claims (13)
- 組織吸引チャンバと針トラックと縫合糸タグキャッチとを備える縫合カプセルを含み、
前記縫合糸タグキャッチは前記組織吸引チャンバより先端側に配置され、
前記針トラック内で摺動可能で前記組織吸引チャンバを貫通する通路に沿って摺動可能な針と、
前記針の外側表面の上にある縫合糸タグロックと、
前記縫合糸タグロックによって前記針の前記外側表面の上に捕捉可能で前記縫合糸タグロックが開放されると前記針から開放されて前記縫合糸タグキャッチの中へ入ることが可能な縫合糸タグとを更に含むことを特徴とする内視鏡型組織縫合装置。 - 前記縫合糸タグロックは前記針の前記外部表面に対して位置を変更して前記縫合糸タグと係合するロック表面を作り出し、該ロック表面は、前記針に対して前記タグが先端方向へ摺動移動することを防止することを特徴とする請求項1に記載の内視鏡型組織縫合装置。
- 前記針の前記外部表面は前記針に対して前記ロックを長手方向に移動したときには前記縫合糸タグロックと係合して前記ロック表面を形成するような形状を構成することを特徴とする請求項2に記載の内視鏡型組織縫合装置。
- 前記縫合糸ロックは少なくとも2個のロックスプラインを含み、該ロックスプラインは、前記針の広がった表面の上を摺動すると開いて前記縫合糸タグが長手方向に移動することを防止する前記ロック表面を形成することを特徴とする請求項3に記載の内視鏡型組織縫合装置。
- 前記縫合糸タグキャッチはその端部の一端でY字状に一緒に接合される2本の弾力性アームを含み、該弾力性アームは各々前記縫合糸タグの表面と係合するように構成された内側に突出するエッジを有するフォーク状の自由端を備えることを特徴とする請求項1に記載の内視鏡型組織縫合装置。
- 前記縫合カプセルは更に空洞を含み、前記空洞は、前記縫合糸タグキャッチの前記弾力性アームが動けるようにしつつ前記縫合糸タグの表面の周囲でぴったり嵌合するように構成されることを特徴とする請求項5に記載の内視鏡型組織縫合装置。
- 前記縫合糸タグは環状で前記針の外側表面の上を摺動することを特徴とする請求項1に記載の内視鏡型組織縫合装置。
- 前記タグは基端と先端とを備え、少なくとも先端で先細になり前記針が組織を貫通して先端方向へ前進するときには小さいプロファイルとなるように構成されることを特徴とする請求項7に記載の内視鏡型組織縫合装置。
- 前記針は中実で槍状の先端を有し直線的に先細になった樽の表面が基端方向と先端方向から延びて中央の直径が大きくなった部分で合体し広がった形状を画成するように構成されることを特徴とする請求項4に記載の内視鏡型組織縫合装置。
- 内視鏡の基端に開放自由なように固定可能な制御ハンドルを更に含み、前記制御ハンドルは内視鏡の作業チャネルを貫通して延在するシャフトに接合された少なくとも1本の長手方向の制御部材を有して前記針の長手方向の移動を制御するように構成されることを特徴とする請求項1に記載の内視鏡型組織縫合装置。
- 前記ハンドルは更に前記針を作動させる前記長手方向の制御部材のストロークの一部の間に前記縫合糸タグロックを作動させるための制御メカニズムを含むことを特徴とする請求項10に記載の内視鏡型組織縫合装置。
- 前記ハンドルの前記長手方向の制御部材は、周回式爪とトラック・メカニズムを含み、前記針を動作させる前記制御メカニズムの前記長手方向ストロークの一部分だけの間に縫合糸タグロック制御シャフトの移動を行なわせるような方向に向けられていることを特徴とする請求項11に記載の内視鏡型組織縫合装置。
- 前記制御ハンドルは前記カプセルの前記吸引チャンバがあらかじめ設定した真空圧に到達するまで前記ハンドル制御部材の長手方向の移動を防止するためのインターロック機能を含む真空制御スイッチを更に含むことを特徴とする請求項10に記載の内視鏡型組織縫合装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US47124803P | 2003-05-16 | 2003-05-16 | |
PCT/US2004/015670 WO2004103189A1 (en) | 2003-05-16 | 2004-05-17 | Single intubation, multi-stitch endoscopic suturing system |
Related Child Applications (1)
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JP2010115361A Division JP2010246939A (ja) | 2003-05-16 | 2010-05-19 | 単一挿管複数回縫合内視鏡型縫合システム |
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JP2007500575A JP2007500575A (ja) | 2007-01-18 |
JP4565218B2 true JP4565218B2 (ja) | 2010-10-20 |
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JP2006533214A Expired - Fee Related JP4565218B2 (ja) | 2003-05-16 | 2004-05-17 | 単一挿管複数回縫合内視鏡型縫合システム |
JP2010115361A Pending JP2010246939A (ja) | 2003-05-16 | 2010-05-19 | 単一挿管複数回縫合内視鏡型縫合システム |
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Country Status (11)
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US (1) | US8075573B2 (ja) |
EP (1) | EP1631201B1 (ja) |
JP (2) | JP4565218B2 (ja) |
CN (1) | CN1822794B (ja) |
AU (1) | AU2004240645B2 (ja) |
BR (1) | BRPI0410376B1 (ja) |
CA (1) | CA2525275C (ja) |
ES (1) | ES2705604T3 (ja) |
MX (1) | MXPA05012303A (ja) |
NO (1) | NO339143B1 (ja) |
WO (1) | WO2004103189A1 (ja) |
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2004
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- 2004-05-17 US US10/847,190 patent/US8075573B2/en active Active
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EP1631201A4 (en) | 2012-04-18 |
EP1631201A1 (en) | 2006-03-08 |
CN1822794B (zh) | 2010-05-26 |
NO339143B1 (no) | 2016-11-14 |
BRPI0410376A (pt) | 2006-06-13 |
WO2004103189A1 (en) | 2004-12-02 |
US8075573B2 (en) | 2011-12-13 |
AU2004240645B2 (en) | 2010-05-13 |
EP1631201B1 (en) | 2018-11-07 |
AU2004240645A1 (en) | 2004-12-02 |
CA2525275A1 (en) | 2004-12-02 |
BRPI0410376B1 (pt) | 2016-06-14 |
NO20055381L (no) | 2005-12-15 |
US20050033319A1 (en) | 2005-02-10 |
CA2525275C (en) | 2012-02-07 |
ES2705604T3 (es) | 2019-03-26 |
JP2010246939A (ja) | 2010-11-04 |
JP2007500575A (ja) | 2007-01-18 |
CN1822794A (zh) | 2006-08-23 |
MXPA05012303A (es) | 2006-02-22 |
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