JP4749681B2 - 使用済みカートリッジに対するロックアウトを備えた外科用ステープラ - Google Patents
使用済みカートリッジに対するロックアウトを備えた外科用ステープラ Download PDFInfo
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- 238000010304 firing Methods 0.000 claims abstract description 207
- 230000007246 mechanism Effects 0.000 claims abstract description 44
- 238000005520 cutting process Methods 0.000 claims description 64
- 230000004044 response Effects 0.000 claims description 13
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- 238000000034 method Methods 0.000 abstract description 10
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- 230000008859 change Effects 0.000 description 1
- 239000011521 glass Substances 0.000 description 1
- 230000001771 impaired effect Effects 0.000 description 1
- 238000005304 joining Methods 0.000 description 1
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- 239000004417 polycarbonate Substances 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
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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
- A61B17/068—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, 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
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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
- A61B17/068—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
- A61B2017/07271—Stapler heads characterised by its cartridge
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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
- A61B17/068—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
- A61B2017/07285—Stapler heads characterised by its cutter
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Description
本願は、それぞれ言及することを以って本明細書の一部とする4つの同時係属中の自己の同時出願に関連する。これらの同時出願の名称は次の通りである。
(1)フレデリック・イー(Frederick E.)、シェルトン4世(Shelton IV)、マイク・セッツァー(Mike Setser)、及びブルース・ウエイスンバーグ(Bruce Weisenburgh)による、「閉じていないアンビルのための発射ロックアウトを備えた外科用ステープラ(SURGICAL STAPLING INSTRUMENT HAVING A FIRING LOCKOUT FOR AN UNCLOSED ANVIL)」。
(2)フレデリック・イー(Frederick E.)、マイク・セッツァー(Mike Setser)、ブライアン・ジェイ(Brian J.)、及びヘンメルガーン(Hemmelgarn)による、「別々の閉止システム及び発射システムを備えた外科用ステープラ(SURGICAL STAPLING INSTRUMENT HAVING SEPARATED DISTINCT CLOSING & FIRING SYSTEMS)」。
(3)フレデリック・イー(Frederick E.)、シェルトン4世(Shelton IV)、マイク・セッツァー(Mike Setser)、及びブルース・ウエイスンバーグ(Bruce Weisenburgh)による、「誤発射防止用の単一ロックアウト機構を備えた外科用ステープラ器具(SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOOUT MECHANISM FOR PREVENTION OF FIRING)」。
(4)フレデリック・イー(Frederick E.)、シェルトン4世(Shelton IV)、マイク・セッツァー(Mike Setser)、及びブルース・ウエイスンバーグ(Bruce Weisenburgh)による、「Eビーム発射機構が組み込まれた外科用ステープラ器具(SURGICAL STAPLING INSTRUMENT INCORPORATING AN E-BEAM FIRING MECHANISM)」。
図2‐図4を参照すると、発射バー14が、発射中にエンドエフェクタ12の間隔を制御する垂直方向に離間した3つのピンを含む。具体的には、上部ピン38が、アンビル18と細長い溝形部材16のピボット近傍のアンビルポケット40内に入るように配置されている。アンビル18が閉じた状態で発射されると、上部ピン38が、アンビル18に形成された先端方向に延びた長手方向のアンビルスロット42内を先端側に移動する。アンビル18における僅かな上方への反りは、上部ピン38による下方への力によって解消される。
Eビーム発射バー14によって提供される正確な垂直空間は、内視鏡装置の制限された空間に適している。更に、Eビーム発射バー14により、図5に示されている位置と同様のその先端部に垂直方向の反りを付与するキャンバーとアンビル16との組立が可能となる。このキャンバーアンビル16は、厚みの薄いアンビル16であってもエンドエフェクタ12に所望のギャップを付与するのに役立つという利点があり、大きさが制限される内視鏡装置に適している。
図6‐図9を参照すると、ガラス充填ポリカーボネートなどのポリマー材料から成形された第1のベース部分50及び第2のベース部分52から構成されるハンドル部分20が示されている。第1のベース部分50は、複数の円筒状のピン54を備えている。第2のベース部分52は、それぞれが六角形の開口58を備えた複数の延出部材56を含む。円筒状のピン54は、六角形の開口58内に受容されて摩擦により保持され、これにより、第1のベース部分50と第2のベース部分52の組立てが維持される。
図10‐図16に、外科用ステープラ/切断器具10のエンドエフェクタ12が詳細に示されている。上記したように、ハンドル部分20により、エンドエフェクタ12の閉止動作と発射動作を別々に行うことができる。このエンドエフェクタ12の別々の閉止及び発射(すなわち、ステープル止め及び切断)が、臨床的な柔軟性を保っているという利点がある。加えて、エンドエフェクタ12は、医師が組織を配置してクランプした後に、発射中の閉止間隔を維持するという前記した能力も提供する。これらの特徴により、この特徴がなければ不十分な量の組織がクランプされる場合に十分な間隔を提供したり、この特徴がなければ過剰な量の組織がクランプされる場合にクランプする力を強くして、外科用ステープラ/切断器具10の能力を手順的及び構造的に高めることができる。
使用する場合、外科用ステープラ/切断器具10は、図1、図2、及び図17‐図23に示されているように用いられる。図1‐図2において、器具10は開始位置にあり、細長い溝形部材16の先端部にスナップ嵌めされた発射されていないステープルが完全に装着されているステープルカートリッジ37を有する。トリガ26及び28は前方の位置にあって、エンドエフェクタ12は開いている。これは体内の内腔内のトロカールまたは他の開口を介して挿入された後の典型的なエンドエフェクタ12である。次いで、図17に示されているように、医師が器具10を操作して、ステープル止め及び切断する組織248をステープルカートリッジ37とアンビル18との間に配置する。
上記したように、Eビーム発射バー14は、エンドエフェクタ12の間隔を確実に維持しながら、組織を切断すると同時にその切断部の両側にステープルを形成できる。発射バー14が先端側へ移動しないようにして、誤った組織の切断を防止することができる。使用済みカートリッジに対するロックアウト機構270は、使用済みステープルカートリッジに応答して発射バー14の中間ピン46をブロックする(図24には、発射バー14の中間ピンのみが示されている)。
(実施態様A)
発射装置を備えた外科器具に用いられるステープルカートリッジであって、
複数のステープルを支持する複数のドライバと、
ウェッジ装置と、
複数のステープル開口と横方向に連通した長手方向のウェッジキャビティを有する本体であって、前記ウェッジキャビティが前記発射装置を受容するために基端側で開口している、前記本体と、
前記ステープル開口に配置された複数のステープルと、
前記ウェッジキャビティから前記ステープル開口に移動できる大きさに形成された前記ステープルを支持する複数のドライブとを含み、
前記ウェッジ装置が、前記ウェッジキャビティの基端側に配置されており、
更に、前記本体に画定されたロックアウト凹部と基端部分と前記発射装置によって横断される前記ウェッジキャビティの基端部分との間で移動可能な、前記本体に連結されたロックアウト装置を含むことを特徴とするステープルカートリッジ。
(1)前記ロックアウト装置が、前記ウェッジキャビティ内に弾性的に進入する先端部を含み、前記先端部が、傾斜した先端面及びブロック用基端面を含むことを特徴とする実施態様Aに記載のステープルカートリッジ。
(2)前記本体が弾性材料を含み、前記ロックアウト装置が、前記本体と一体に形成された先端側に延びた先端部を備えた基端側に延びたフィンガを含むことを特徴とする実施態様(1)に記載のステープルカートリッジ。
(3)前記ロックアウト装置が、前記本体にばね作用するように取り付けられた可動部材を含むことを特徴とする実施態様(1)に記載のステープルカートリッジ。
(4)前記発射装置が垂直切断縁を備えた発射バーを含み、前記ステープル本体が、前記垂直切断縁を受容するように適合された基端側が開口した垂直スロットを含むことを特徴とする実施態様Aに記載のステープルカートリッジ。
(5)前記発射バーが、前記細長い溝形部材にスライド可能に係合するように前記切断縁を横断して延出したピンを含み、前記ステープルカートリッジの前記本体が更に、前記ピンを受容するように適合された発射駆動スロットを含み、前記ロックアウト機構が更に、前記垂直スロットから横方向に偏位して配置された、前記ピンに係合する一対の可動本体を含むことを特徴とする実施態様(4)に記載のステープルカートリッジ。
外科器具であって、
閉止動作及び発射動作を起こすためのハンドル部分と、
前記閉止動作に応答して組織をクランプし、前記発射動作に応答して前記クランプされた組織を切断するための実施手段と、
前記発射動作に応答して前記切断された組織をステープル止めし、ステープルの使用済み状態に応答して発射を防止するステープラ手段とを含むことを特徴とする外科器具。
(実施態様C)
外科器具であって、
回動可能に対向した一対のジョーと、
前記対向したジョーの間で長手方向に移動できるように配置された発射バーと、
前記対向したジョーを閉じて前記発射バーを発射するように機能的に構成されたハンドル部分と、
前記対向したジョー内に装着可能なステープル装置とを含み、
前記ステープル装置が、当初は基端側に配置されるが、前記発射バーの発射によって先端側に配置されるウェッジ装置と、前記ウェッジ装置の先端側への配置に応答して、その後の前記発射バーの先端側への移動をブロックするべく弾性的に変位するように配置されたロックアウト装置とを含むことを特徴とする外科器具。
(6)前記ステープル装置が、複数のステープルを支持する複数のドライバと、ウェッジ装置と、複数のステープル開口と横方向に連通した長手方向のウェッジキャビティを有する本体であって、前記ウェッジキャビティが前記発射装置を受容するために基端側で開口している、前記本体と、前記ステープル開口に配置された複数のステープルと、前記ウェッジキャビティから前記ステープル開口に移動できる大きさに形成された前記ステープルを支持する複数のドライブとを含み、前記ウェッジ装置が、前記ウェッジキャビティの基端側に配置されており、更に、前記本体に画定されたロックアウト凹部と基端部分と前記発射装置によって横断される前記ウェッジキャビティの基端部分との間で移動可能な、前記本体に連結されたロックアウト装置を含むことを特徴とする実施態様Cに記載の外科器具。
(7)前記ロックアウト装置が、前記ウェッジキャビティ内に弾性的に進入する先端部を含み、前記先端部が、傾斜した先端面及びブロック用基端面を含むことを特徴とする実施態様(6)に記載の外科器具。
(8)前記本体が弾性材料を含み、前記ロックアウト装置が、前記本体と一体に形成された先端側に延びた先端部を備えた基端側に延びたフィンガを含むことを特徴とする実施態様(7)に記載の外科器具。
(9)前記ロックアウト装置が、前記本体にばね作用するように取り付けられた可動部材を含むことを特徴とする実施態様(7)に記載の外科器具。
(10)前記発射装置が垂直切断縁を備えた発射バーを含み、前記ステープル本体が、前記垂直切断縁を受容するように適合された基端側が開口した垂直スロットを含むことを特徴とする実施態様(6)に記載の外科器具。
(11)前記発射バーが、前記細長い溝形部材にスライド可能に係合するように前記切断縁を横断して延出したピンを含み、前記ステープルカートリッジの前記本体が更に、前記ピンを受容するように適合された発射駆動スロットを含み、前記ロックアウト機構が更に、前記垂直スロットから横方向に偏位して配置された、前記ピンに係合する一対の可動本体を含むことを特徴とする実施態様(10)に記載の外科器具。
12 エンドエフェクタ
14 Eビーム発射機構または発射バー
16 溝形部材
18 アンビル
20 ハンドル部分
22 実施部分
23 シャフト
24 ピストルグリップ
26 閉止トリガ
28 発射トリガ
30 解放ボタン
32 閉止スリーブ
34 フレーム
36 発射駆動部材
37 ステープルカートリッジ
38 上部ピン
40 アンビルポケット
42 アンビルスロット
44 発射バーキャップ
45 スロット
46 中間ピン
47 発射駆動スロット
48 切断縁
49 垂直スロット
50 第1のベース部分
52 第2のベース部分
54 円筒状ピン
56 延出部材
58 六角形開口58
60 回動ノブ
62 貫通孔
64 ボス
70 外周ノッチ
72 溝形部材固定部材
74 ハンドル部分
76 ギア部分
78 中間部分
86 ヨーク
89 凹部
102、112、124 ばね
104 第1のクランプフック
118 上部ラッチアーム
122 凹部
128 係合面
130 前面
136 マルチプライヤ
138 駆動部材
140 金属製駆動ロッド
141 第1のギアラック
142 第2のギアラック
144 ノッチ
146 歯
148 第2のノッチ
150 第1のピニオンギア
152 第2のピニオンギア
154 第1のギアラック
156 ギア部分
204 ステープラ開口
208、210 延長構造
212、214 凹部
216 カートリッジ本体
218 ウェッジスレッド
220 シングルドライバ、ダブルドライバ
222 ステープル
224 カートリッジトレイ
226 取付けキャビティ
227 アンカー部材
228 ウェッジ
230 アンビルカムスロット
232 アンビルピボット
234 タブ
236 アンビルカム構造
238 発射コネクタ
239 スロットガイド
246 傾斜部分
248 組織
250 発射バーストッパー
270、290 ロックアウト機構
272、294 カートリッジ本体
274 ブロック部材
276 キャビティ
278 ウェッジスレッド
280 可撓性端部
292 ロックアウトフック
296 ウェッジ状凹部
298 シャフト
300 フック端部
Claims (7)
- 発射装置を備えた外科器具に用いられ、基端部および先端部を有するステープルカートリッジであって、
複数のステープルを支持する複数のドライバと、
初期位置では基端側に配置され、前記発射装置の発射により先端側に移動し、先端位置に残されるウェッジスレッドと、
複数のステープル開口と横方向に連通した長手方向のウェッジキャビティを有する本体であって、前記ウェッジキャビティが前記ウェッジスレッドを受容するために基端側で開口している、前記本体と、
前記ステープル開口に配置された複数のステープルと、
カートリッジトレイと、
前記本体と前記カートリッジトレイとの間に形成された発射駆動スロットであって、前記発射装置が通過する発射駆動スロットと、
前記本体に連結しており前記本体に組み込まれている移動可能なブロック部材を有するロックアウト装置と、を備えており、
複数のドライバは、前記ウェッジキャビティから前記ステープル開口に移動できる大きさに形成された前記ステープルを支持し、
前記ブロック部材は、前記本体に画定されたロックアウト凹部内の位置と前記発射装置が通過する前記発射駆動スロットの基端部の位置との間で移動でき、
前記ウェッジスレッドは、未発射位置である前記ウェッジキャビティの基端側に位置しているとき、前記ブロック部材の可撓性端部を前記ロックアウト凹部内に押し込んでおり、これによって前記発射装置が先端側に移動することが妨げられず、
前記発射装置が発射して、前記ウェッジスレッドが前記ブロック部材の可撓性端部を通り抜けた場合、前記ブロック部材の前記可撓性端部は、前記発射駆動スロット内に開放されて、発射装置が引き戻された位置から先端側に移動することが阻止されることを特徴とするステープルカートリッジ。 - 前記ブロック部材の前記可撓性端部は、傾斜した先端部及びブロック用基端部を含むことを特徴とする請求項1に記載のステープルカートリッジ。
- 前記本体が弾性材料を含み、前記ロックアウト装置が、前記本体と一体に形成されており突出しているフック端部を備えた基端側に延びたフィンガを含むことを特徴とする請求項2に記載のステープルカートリッジ。
- 前記ロックアウト装置の前記ブロック部材が、前記本体にばね作用するように取り付けられていることを特徴とする請求項2に記載のステープルカートリッジ。
- 外科器具であって、
閉止動作及び発射動作を起こすためのハンドル部分と、
前記閉止動作に応答して組織をクランプし、前記発射動作に応答して前記クランプされた組織を切断するための実施手段と、
前記発射動作に応答して前記切断された組織をステープル止めし、ステープルの使用済み状態に応答して発射を防止するステープラ手段と、を備え、
前記外科器具は、更に、
回動可能に対向した一対のジョーと、
前記対向したジョーの間で長手方向に移動できるように配置された発射装置と、
前記対向したジョーを閉じて前記発射装置を発射するように機能的に構成された前記ハンドル部分と、
前記対向したジョー内に装着可能な請求項1〜4の何れか1項のステープルカートリッジと、を含むことを特徴とする外科器具。 - 前記発射装置が垂直切断縁を備えた発射バーを含み、前記本体が、前記垂直切断縁を受容するように適合された基端側が開口した垂直スロットを含むことを特徴とする請求項5に記載の外科器具。
- 前記発射バーが、前記発射駆動スロットにスライド可能に係合するように前記切断縁を横断して延出したピンを含み、前記ロックアウト機構が、前記垂直スロットから横方向に偏位して配置された、前記ピンに係合する一対の可動本体を含むことを特徴とする請求項6に記載の外科器具。
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US441565 | 2003-05-20 | ||
US10/441,565 US6988649B2 (en) | 2003-05-20 | 2003-05-20 | Surgical stapling instrument having a spent cartridge lockout |
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JP4749681B2 true JP4749681B2 (ja) | 2011-08-17 |
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JP2004149536A Expired - Lifetime JP4749681B2 (ja) | 2003-05-20 | 2004-05-19 | 使用済みカートリッジに対するロックアウトを備えた外科用ステープラ |
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US (1) | US6988649B2 (ja) |
EP (1) | EP1479345B1 (ja) |
JP (1) | JP4749681B2 (ja) |
AT (1) | ATE404127T1 (ja) |
AU (2) | AU2004202204A1 (ja) |
CA (1) | CA2467885C (ja) |
DE (1) | DE602004015669D1 (ja) |
MX (1) | MXPA04004886A (ja) |
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2003
- 2003-05-20 US US10/441,565 patent/US6988649B2/en not_active Expired - Lifetime
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2004
- 2004-05-19 JP JP2004149536A patent/JP4749681B2/ja not_active Expired - Lifetime
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- 2004-05-20 DE DE602004015669T patent/DE602004015669D1/de not_active Expired - Lifetime
- 2004-05-20 EP EP04252975A patent/EP1479345B1/en not_active Expired - Lifetime
- 2004-05-20 CA CA2467885A patent/CA2467885C/en not_active Expired - Fee Related
- 2004-05-20 AT AT04252975T patent/ATE404127T1/de not_active IP Right Cessation
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MXPA04004886A (es) | 2004-11-25 |
AU2010214808B2 (en) | 2011-09-15 |
AU2010214808A1 (en) | 2010-09-23 |
AU2004202204A1 (en) | 2004-12-09 |
ATE404127T1 (de) | 2008-08-15 |
CA2467885A1 (en) | 2004-11-20 |
CA2467885C (en) | 2012-02-21 |
US6988649B2 (en) | 2006-01-24 |
DE602004015669D1 (de) | 2008-09-25 |
US20040232200A1 (en) | 2004-11-25 |
JP2004344660A (ja) | 2004-12-09 |
EP1479345A1 (en) | 2004-11-24 |
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