JP5179024B2 - 二重ピボットクロージャおよび単一ピボットフレームグラウンドを備えた関節運動シャフトを有する外科用器械 - Google Patents
二重ピボットクロージャおよび単一ピボットフレームグラウンドを備えた関節運動シャフトを有する外科用器械 Download PDFInfo
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Description
本発明は、ケネス・ウェールス(Kenneth Wales)およびチャド・ブードロー(Chad Boudreaux)名義で2005年2月18日に出願された同一所有者による米国特許出願第11/061,908号(発明の名称:SURGICAL INSTRUMENT INCORPORATING A FLUID TRANSFER CONTROLLED ARTICULATION MECHANISM)に関するものであってこの出願の権益主張出願であり、この米国特許出願を参照することにより、その開示内容全体を本明細書の一部とする。
本発明は一般に、内視鏡下でエンドエフェクタ(例えば、体内カッタ、把持器、カッタ、ステープラ、クリップ留め具、接近用器具、薬物/遺伝子治療送達器具および超音波、RF、レーザ等を利用したエネルギー器具)を手術部位に挿入するのに適した外科用器械、特に、関節運動シャフトを備えたかかる外科用器械に関する。
内視鏡下外科用器械は、切開部が小さいほうが術後回復期間および合併症を減少させる傾向があるので、伝統的な開放式外科用器具よりも好ましい場合が多い。したがって、トロカールのカニューレを通って遠位エンドエフェクタを所望の手術部位に正確に配置するのに適した内視鏡下外科用器械類の大々的な開発が行われた。これら遠位エンドエフェクタ(例えば、体内カッタ、把持器、カッタ、ステープラ、クリップ留め具、接近用器具、薬物/遺伝子治療送達器具および超音波、RF、レーザ等を利用したエネルギー器具)は、診断効果または治療効果を達成するのに多くの仕方で組織に係合する。
E. Shelton IV)等名義の同一所有者による同時係属米国特許出願第10/615,973号(発明の名称:SURGICAL INSTRUMENT INCORPORATING AN ARTICULATION MECHANISM HAVING ROTATION ABOUT THE LONGITUDINAL AXIS)において、回転運動が、長手方向運動に代わる手段として関節運動を伝達するために用いられ、この米国特許出願を参照することにより、その開示内容全体を本明細書の一部とする。
本発明は、回動可能な上側ジョーまたはアンビルを含むエンドエフェクタに回動自在に取り付けられているフレームを備えたシャフトを有する外科用器械を提供することにより先行技術の上述の問題および他の問題を解決する。クロージャ管が、フレーム上で摺動して組織を閉じてクランプするようアンビルの回動を生じさせる。このクロージャ管が関節継手上を長手方向に並進するようにするために、クロージャトリップは、それ自体の二重回動継手を有している。
関節運動シャフトの概要
図面を参照すると(幾つかの図にわたり、同一の符号は同一の部品を示している)、図1は、外科用器械を示しており、この外科用器械は、図示の形態では、本発明の独特の利点をもたらすことができる特に外科用ステープル留め兼用切断器械10である。特に、外科用ステープル留め兼用切断器械10は、外科手技を実施するために図1に示すような非関節運動状態でトロカールカニューレ通路を通って患者(図示せず)の体内の手術部位まで挿入可能に寸法決めされている。作業部分12をいったんカニューレ通路中へ挿入すると、作業部分12の細長いシャフト16の遠位部分内に組み込まれた関節運動機構14を図2に示すように関節運動制御装置18によって遠隔的に関節運動させることができる。図示の形態では、ステープル留め組立体20として示されたエンドエフェクタが、関節運動機構14の遠位側に取り付けられている。かくして、関節運動機構14を遠隔的に関節運動させることにより、ステープル留め組立体20は、細長いシャフト16の長手方向軸線から関節運動する。このような傾斜位置は、切断およびステープル留めのために所望の角度から組織に接近し、あるいは他の臓器および組織により遮られた組織に接近するとともに(あるいは)配置状態を確認するために内視鏡をステープル留め組立体20の後ろに位置決めしてこれと整列させることができるという点において有利な場合がある。
外科用ステープル留め兼用切断器械10は、作業部分12の近位側に連結されていて、位置決め運動、関節運動、閉鎖運動および発火運動をこの作業部分にもたらす取っ手部分22を有している。取っ手部分22は、ピストル型握り24を有し、ステープル留め組立体20の締め付けまたは閉鎖を生じさせるよう臨床医によってクロージャトリガ26がこの握り24に向かって回動的にかつ近位側へ引き寄せられる。発火トリガ28が、クロージャトリガ26の一段と外側に位置し、この発火トリガは、ステープル留め組立体20内にクランプされたクランプ状態の組織のステープル留めおよび切断を生じさせるよう臨床医によって回動的に引かれる。しかる後、クロージャ解除ボタン30を押して固定状態のクロージャトリガ26を解除し、かくしてクランプ状態の組織の切断およびステープル留め端部を解除する。取っ手部分22は、シャフト16およびこれに関節連結されたステープル留め組立体20をシャフト16の長手方向軸線回りに回転させるよう細長いシャフト16と一緒に運動できるよう結合された回転ノブ32を更に有している。取っ手部分22は、もし万が一つかえが生じた場合発火機構(図1または図2には示さず)を引き戻すのを助け、ステープル留め組立体20の開放がその後に生じることができるようにする発火引き戻し取っ手34を更に有する。
図3〜図5では、作業部分12は有利には、内視鏡下および腹腔鏡下手技に適した小径内で長手方向回転運動、関節運動、閉鎖運動および発火運動の多数の作動運動を含む。ステープル留め組立体20(「エンドエフェクタ」)は、回動自在に取り付けられたアンビル42(図1、図2、図4および図5)を備えた細長いチャネル40として示されている1対の回動自在に取り付けられた向かい合ったジョーを有する。アンビル42を閉鎖して細長いチャネル40に固定することは、フレーム組立体44(図3)が取っ手部分22に回転自在に取り付けられた状態で細長いチャネル40の長手方向に支持することによって達成され、二重ピボットクロージャスリーブ組立体46は、このフレーム組立体44上で、長手方向に動いて、ステープル留め組立体20が図2に示すように関節運動していても、それぞれ遠位および近位運動のための閉鎖および開放作用をアンビル42に与える。
図4および図5を参照すると、発火バー66は、E−ビーム165の遠位側で終端しており、このE−ビームは、アンビル42に設けられたアンビルスロット168に入ってアンビル42を確認してこれをステープル配列および切断中、閉鎖状態に維持するのを助ける上側案内ピン166を有している。細長いチャネル40とアンビル42との間の間隔は、中間ピン170を細長いチャネル40の頂面に沿って摺動させる一方で、底部足部172が細長いチャネル40に設けられた長手方向開口部174によって案内された状態で細長いチャネル40の下面に沿ってこれに対向して摺動することによりE−ビーム164によって更に維持される。上側案内ピン166と中間ピン170との間に位置するE−ビーム164の遠位側に設けられた切断面176は、クランプされた状態の組織を切断し、他方、E−ビームは、くさび形そり180を遠位側に移動させ、それによりステープルドライバ182が、上方に駆動するステープル184をカム駆動してこれをステープルカートリッジ本体188に設けられている上方に開口したステープル穴186から出してアンビル42のステープル配列下面190に押し付けて配列することにより交換可能なステープルカートリッジ178を作動させる。ステープルカートリッジトレイ192が、ステープルカートリッジ178の他の部品を底部から包囲してこれらを定位置に保持する。ステープルカートリッジトレイ192は、細長いチャネル40の長手方向開口部174の上に位置する後方に開口したスロット194を有し、かくして、中間ピン170が、ステープルカートリッジトレイ192の内部を通る。
図3、図4および図6〜図8では、関節運動ロック機構200が、有利には、ステープル留め組立体20を所望の関節角度に維持するよう組み込まれている。関節運動ロック機構200は、左側作動ブラダ100および右側作動ブラダ102に加わる荷重を減少させる。特に、圧縮ばね202(図3)が、関節運動ロック部材111の近位端204と取っ手部分22との間に近位側に位置決めされていて、関節運動ロック部材111を遠位側に付勢している。特に図4を参照すると、関節運動ロック部材111の遠位端210のところに設けられた2つの平行なスロット206,208が、フレームグラウンド48に設けられた上方に突き出ている案内リブ212,214をそれぞれ受け入れる。案内リブ212,214は、平行なスロット206,208よりも長手方向に短く、或る範囲の相対的な長手方向移動を可能にしている。それにより、特に図8を参照すると、関節運動ロック部材111から遠位側に突き出た歯付き凹部216として示されている遠位摩擦面の選択的な当接係合は、関節運動フレーム部材114の頂部近位凹部220内に受け入れられたブレーキ板218に設けられている対応のロック歯車セグメント217に連係している。ブレーキ板218に設けられた遠位穴221および近位穴222は、頂部近位凹部220から上方に突き出た遠位ピン223および近位ピン224を受け入れる。
SURGICAL INSTRUMENT)に詳細に記載されており、参照によりその開示内容全体を本明細書の一部とする。
図3、図4および図7を参照すると、作業部分12は有利には、単一ピボットフレームグラウンド48上に長手方向に並進してこれを包囲する二重ピボットクロージャスリーブ組立体46を有する。これら機構およびこれらの作用について以下に詳細に説明する。特に図7を参照すると、関節運動機構14は、クロージャスリーブ組立体46がアンビル開放状態に向かって近位側に引っ込められた状態の関節運動状態で示されている。アンビル42が開放した状態で、関節運動制御装置18を作動させると、関節運動クロージャリング116が、上側および下側二重ピボットクロージャリンク134,140のそれぞれの上方に差し向けられた遠位ピン136および下方に差し向けられた遠位ピン142の周りを回動する。フレームグラウンド48は、フレームグラウンド48を遠位フレーム部材114に接合する近位ピン157として示された単一のピンの周りを回動する。アンビル42が開放した状態では、フレームグラウンド48の近位ピン147は、クロージャスリーブ組立体46の上側および下側二重ピボットリンク134,140の最も遠位側の位置と整列する。この位置決めにより、アンビル42が開いた状態で、ステープル留め組立体20の容易な回動および回転が可能である。クロージャスリーブ組立体46を遠位側へ移動させてアンビル42を回動させてこれを閉鎖すると、真っ直ぐなクロージャ管52は、フレームグラウンド48の周りを遠位側に動き、関節運動クロージャリング116は、ピボットリンク134,140により押圧されると、関節運動遠位フレーム部材114の軸線に沿って遠位側へ動く。リンク134,140のそれぞれの二重ピボットピン136,138および142,144は、器具(図示せず)を関節運動させたときにこれらが遠位閉鎖位置に向かって押圧されると、真っ直ぐなクロージャ管52および関節運動クロージャリング116との係合を容易にする。遠位閉鎖位置では、フレームグラウンドピボットピン(「近位ピン」)147は、完全関節運動時に近位ピボットピン138,144と垂直方向に整列しまたは効果的に働いている状態で遠位ピン136,142と近位ピン138,144との間の任意の箇所に位置することができる。
図8では、図7の関節運動機構14は、部分的に分解され、下から見た状態で示され、従来型可撓性支持板と比べて利点をもたらす中実壁発火バー支持体設計(ドッグボーン形リンク160)を示している。支持板は、隙間を橋渡しし、発火バー66を単一フレームグラウンドピボット関節運動継手1801中を支持した状態で案内するために用いられる。可撓性発火バーは、公知であるが、例えば図4、図8および図9に示すような中実壁発火バーを設けると、独特な利点が得られる。次に図8を参照すると、フレームグラウンド48は、フレームグランド48の底部に沿って延びるフレームナイフスロット1802を有し、遠位ナイフスロット164が、発火バー66(図示せず)を摺動自在に受け入れるために関節運動遠位フレーム部材114の底部に沿って延びている。上述したフレームグラウンド48は、遠位フレーム部材114との直接的な単一回動連結部157を有する。ピンの近位端157に回転自在に連結され、ピンの遠位端159に可動的に連結された固定壁ドッグボーン形リンク160は、左側方ガイド1818および右側方ガイド1820を有し、これらガイド相互間には、発火バー66(図4)の摺動通過用の案内スロット1822が定められている。
さらに図9を参照すると、フレームグラウンド1916に設けられた左および右上向きフランジ1918,1920が、T−バー1926に設けられた穴を側方に通過して関節運動機構1928のつかえを最小限に抑えるのを助ける遠位および近位側方ピンガイド1922,1924を有している。別の例として、図7において、T−バー104は有利には、ダブテール形側方ガイド1930を有し、この側方ガイドは、T−バーに形成されたダブテール形チャネル1932内で側方に摺動する。さらに別の例として、図12において、フレームグラウンド1936に設けられた隆起リブ1934が、T−バー1940に形成された矩形スロット1938内に受け入れられている。つかえを生じない側方並進を一段と容易にするため、遠位および近位側方支承軌道は各々、それぞれ複数の玉軸受1946,1948を有している。さらに別の例として、図13において、複数個のフレーム側方溝1950〜1954が、フレームグラウンド1956に形成され、これに対応したT−バー側方溝1958〜1962がT−バー1964に設けられている。摺動ローラ1966〜1970が、それぞれ対をなす側方溝1950/1958,1952/1960,1954/1962内に捕捉された状態で位置している。これらは、T−バー1940の望ましくない起動または回転を阻止する側方案内部材の全てではない。
図14および図15では、別のフレームグラウンドおよび閉鎖機構2200が、二重ピボットフレーム組立体2204を有する外科用器械2202を有している。特に、フレームグラウンド2206は、二重ピボットフレームドッグボーン2210により遠位フレーム部材2208に連結され、この二重ピボットフレームドッグボーンは、フレームグラウンド2206に設けられた近位ボア2214に回動自在に係合する近位ピボットピン2212および遠位フレーム部材2208の遠位ボア2218に係合する遠位ピボットピン2216を有する。発火バー66(図14および図15には示さず)を収納状態で案内する案内スロット2220が、ドッグボーン2210の下面に設けられている。ナイフスロット2222が、遠位フレーム部材2208に設けられている。図示のように、クロージャリング2230を45°の角度まで関節運動させることにより、遠位フレーム部材2208が45°の角度まで関節運動するとともにフレームドッグボーン2210がその角度の半分まで関節運動する。その結果、発火バー66は、互いに間隔を置いた2つの浅い半分の曲げを受け、上述した利点の全てを有する。
図16では、外科用器械2402用の作業部分2412は、多ピボットクロージャ組立体2404を有する。最も外側に位置するクロージャスリーブ組立体2424は、可撓性クロージャ継手2425によってクロージャ管シャフト2426に取り付けられており、このクロージャ継手2425は、単一ピボットフレーム関節運動継手(図16には示さず)を包囲している。変形例として、屈曲ネック型フレーム関節運動継手を包囲してもよい。多ピボットクロージャ組立体2404は、弾性材料(例えば、ポリマー、シリコーン)に形成された左側および右側の垂直スリット2427,2429を有することにより側方に可撓性を有する。頂部および底部材料バンド2451が、可撓性クロージャ継手2425の長手方向長さを維持し、発火運動を伝達する。
(1)外科用器械において、
フレーム組立体およびクロージャスリーブ組立体を有する細長いシャフトと、
下側ジョーおよび回動自在に取り付けられた上側ジョーを有するエンドエフェクタと、
前記エンドエフェクタの前記下側ジョーを前記フレーム組立体の遠位端部に回動自在に取り付ける関節運動継手と、
前記細長いシャフトの近位端部に取り付けられていて、閉鎖運動を前記クロージャスリーブ組立体に長手方向に結合するよう作動的に構成された取っ手部分と、
前記関節運動継手を包囲していて、前記上側ジョーの回動を引き起こすよう前記上側ジョーに遠位側で係合した前記クロージャスリーブ組立体の多ピボット継手と、
を有する、外科用器械。
(2)実施態様(1)記載の外科用器械において、
前記クロージャスリーブ組立体は、前記アンビルに係合した遠位クロージャ管部分と、前記取っ手部分に結合された近位クロージャ管部分と、を更に有し、前記クロージャスリーブ組立体の前記多ピボット継手は、各々が2つの端部の各々のところでそれぞれ前記遠位クロージャ管部分および前記近位クロージャ管部分に回動自在に取り付けられた上側二重ピボットリンクおよび下側二重ピボットリンクを有する、外科用器械。
(3)実施態様(2)記載の外科用器械において、
前記遠位クロージャ管部分は、近位側へ差し向けられたクレビスおよび該クレビスに取り付けられた第1の円筒形部材を更に有し、前記近位クロージャ管部分は、遠位側へ差し向けられたクレビスおよび該クレビスに取り付けられた第2の円筒形部材を更に有する、外科用器械。
(4)実施態様(1)記載の外科用器械において、
前記フレーム組立体は、前記下側ジョーに取り付けられた遠位フレーム部分と、前記取っ手部分に取り付けられた近位フレーム部分と、一端が前記遠位フレーム部分および前記近位フレーム部分のうちの選択された一方に剛性的に取り付けられるとともに他端部が前記遠位フレーム部分および前記近位フレーム部分のうちの他方に回動自在に取り付けられたフレーム回動アームと、を更に有する、外科用器械。
(5)実施態様(4)記載の外科用器械において、
前記フレーム回動アームは、発火バーを案内するナイフスロットを有する、外科用器械。
(6)実施態様(1)記載の外科用器械において、
前記下側ジョーは、ステープルカートリッジを収容する細長いチャネルを有し、前記回動自在に取り付けられた上側ジョーは、ステープル形成面を備えたアンビルを有する、外科用器械。
(7)実施態様(1)記載の外科用器械において、
前記フレーム組立体は、前記下側ジョーに取り付けられた遠位フレーム部分と、前記取っ手部分に取り付けられた近位フレーム部分と、を更に有し、前記遠位フレーム部分および前記近位フレーム部分は、前記他方に互いにオーバーラップした状態で回動自在に取り付けられた端部を提供する、外科用器械。
(8)実施態様(1)記載の外科用器械において、
クロージャスリーブ組立体の多ピボット継手は、遠位円筒形部材と、該部材に取り付けられた可撓性クロージャ継手と、前記可撓性クロージャ継手に取り付けられた近位円筒形部材と、を更に有する、外科用器械。
(9)実施態様(8)記載の外科用器械において、
前記可撓性クロージャ継手は、弾性材料で形成され、左側および右側の列をなす垂直スリットを含む円筒形スリーブを有する、外科用器械。
フレーム組立体および該フレーム組立体を包囲する長手方向に摺動自在に受け入れられたクロージャスリーブ組立体を有する細長いシャフトと、
細長いチャネルと、該細長いチャネル内に嵌め込まれたステープルカートリッジと、前記細長いチャネルに回動自在に取り付けられ、前記ステープルカートリッジに対してステープル形成面を提供するアンビルと、を有するステープル留め組立体と、
前記細長いチャネルに取り付けられた遠位フレーム部分および該遠位フレーム部分に回動自在に取り付けられた近位フレーム部分を有する、前記フレーム組立体と、
前記近位フレーム部分の近位端部に取り付けられていて、閉鎖運動を前記クロージャスリーブ組立体に長手方向に結合するよう作動的に構成された取っ手部分と、
関節運動継手を包囲し、前記上側ジョーの回動を引き起こすよう前記上側ジョーに遠位側で係合した前記クロージャスリーブ組立体の多ピボット継手と、
を具備する、外科用器械。
(11)実施態様(10)記載の外科用器械において、
前記クロージャスリーブ組立体は、前記アンビルに係合した遠位クロージャ管部分と、前記取っ手部分に結合された近位クロージャ管部分と、を更に有し、前記クロージャスリーブ組立体の前記多ピボット継手は、各々が2つの端部の各々のところでそれぞれ前記遠位クロージャ管部分および前記近位クロージャ管部分に回動自在に取り付けられた上側二重ピボットリンクおよび下側二重ピボットリンクを有する、外科用器械。
(12)実施態様(11)記載の外科用器械において、
前記遠位クロージャ管部分は、近位側へ差し向けられたクレビスおよび該クレビスに取り付けられた第1の円筒形部材を更に有し、前記近位クロージャ管部分は、遠位側へ差し向けられたクレビスおよび該クレビスに取り付けられた第2の円筒形部材を更に有する、外科用器械。
(13)実施態様(10)記載の外科用器械において、
前記フレーム組立体は、前記下側ジョーに取り付けられた遠位フレーム部分と、前記取っ手部分に取り付けられた近位フレーム部分と、一端が前記遠位フレーム部分および前記近位フレーム部分のうちの選択された一方に剛性的に取り付けられるとともに他端部が前記遠位フレーム部分および前記近位フレーム部分のうちの他方に回動自在に取り付けられたフレーム回動アームと、を更に有する、外科用器械。
(14)実施態様(13)記載の外科用器械において、
前記フレーム回動アームは、発火バーを案内するナイフスロットを有する、外科用器械。
(15)実施態様(10)記載の外科用器械において、
前記下側ジョーは、ステープルカートリッジを収容する細長いチャネルを有し、前記回動自在に取り付けられた上側ジョーは、ステープル形成面を備えたアンビルを有する、外科用器械。
(16)実施態様(10)記載の外科用器械において、
前記フレーム組立体は、前記下側ジョーに取り付けられた遠位フレーム部分と、前記取っ手部分に取り付けられた近位フレーム部分と、を更に有し、前記遠位フレーム部分および前記近位フレーム部分は、前記他方に互いにオーバーラップした状態で回動自在に取り付けられた端部を提供する、外科用器械。
(17)実施態様(10)記載の外科用器械において、
クロージャスリーブ組立体の多ピボット継手は、遠位円筒形部材と、該部材に取り付けられた可撓性クロージャ継手と、前記可撓性クロージャ継手に取り付けられた近位円筒形部材と、を更に有する、外科用器械。
(18)実施態様(17)記載の外科用器械において、
前記可撓性クロージャ継手は、弾性材料で形成され、左側および右側の列をなす垂直スリットを含む円筒形スリーブを有する、外科用器械。
フレーム組立体および該フレーム組立体を包囲する長手方向に摺動自在に受け入れられたスリーブ組立体を有する細長いシャフトと、
作動部材を含むエンドエフェクタと、
前記エンドエフェクタに取り付けられた遠位フレーム部分および該遠位フレーム部分に回動自在に取り付けられた近位フレーム部分を有する、前記フレーム組立体と、
前記近位フレーム部分の近位端部に取り付けられていて、長手方向運動を前記スリーブ組立体に長手方向に結合するよう作動的に構成された取っ手部分と、
関節運動継手を包囲し、前記エンドエフェクタの前記作動部材の作動を引き起こすよう前記エンドエフェクタの前記作動部材に遠位側で係合した前記スリーブ組立体の多ピボット継手と、
を具備する、外科用器械。
(20)実施態様(19)記載の外科用器械において、
前記スリーブ組立体は、前記エンドエフェクタの前記作動部材に係合した遠位管部分と、前記取っ手部分に結合された近位管部分と、を更に有し、前記スリーブ組立体の前記多ピボット継手は、各々が2つの端部の各々のところでそれぞれ前記遠位管部分および前記近位管部分に回動自在に取り付けられた上側二重ピボットリンクおよび下側二重ピボットリンクを有する、外科用器械。
(21)実施態様(19)記載の外科用器械において、
前記スリーブ組立体の前記多ピボット継手は、弾性材料で形成され、左側および右側の列をなす垂直スリットを含む円筒形スリーブを有する、外科用器械。
12 作業部分
14,230,300,400,2002 関節運動機構
16 細長いシャフト
18 関節運動制御装置
20 ステープル留め組立体またはエンドエフェクタ
22 取っ手部分
24 ピストル型握り
26 クロージャトリガ
28 発火トリガ
30 クロージャ解除ボタン
46 クロージャスリーブ組立体
44 フレーム組立体
80 関節運動アクチュエータ
94 流体関節運動システム
116 関節クロージャ管
178 交換可能なステープルカートリッジ
200,2000 関節運動ロック機構
1801 関節運動継手
1900,2004 外科用器械
Claims (13)
- 外科用器械において、
フレーム組立体(44)および前記フレーム組立体を長手方向に摺動自在に包囲するクロージャスリーブ組立体(46;2424)を備える細長いシャフト(16)と、
下側ジョーおよび回動自在に取り付けられた上側ジョーを備えるエンドエフェクタ(20)と、
前記エンドエフェクタの前記下側ジョーを前記フレーム組立体の遠位端部に回動自在に取り付ける関節運動継手と、
前記細長いシャフトの近位端部に取り付けられていて、閉鎖運動を前記クロージャスリーブ組立体に長手方向に結合するよう作動的に構成された取っ手部分(22)と、
を具備し、
前記フレーム組立体は、
前記下側ジョーに取り付けられた遠位フレーム部分(114)と、
前記取っ手部分に取り付けられた近位フレーム部分(48)と、
を含み、
前記関節運動継手は第1のピボット点を定め、前記第1のピボット点周りで前記遠位フレーム部分が前記近位フレーム部分に対して回動可能であり、
前記クロージャスリーブ組立体は、
前記関節運動継手を包囲していて、前記上側ジョーの回動を引き起こすよう前記上側ジョーに遠位側で係合し、複数のピボット点を有するピボット継手、
を含み、
前記クロージャスリーブ組立体は、
遠位クロージャ部材と、
近位クロージャ部材と、
を更に含み、
前記クロージャスリーブ組立体の前記ピボット継手は、前記近位クロージャ部材を前記遠位クロージャ部材に連結する少なくとも1つのリンクを含み、前記少なくとも1つのリンクは第2のピボット点および第3のピボット点を定め、前記遠位クロージャ部材は、前記第2のピボット点周り、および前記第3のピボット点周りで、前記近位クロージャ部材に対して回動可能である、外科用器械。 - 請求項1記載の外科用器械において、
前記クロージャスリーブ組立体の前記遠位クロージャ部材は、前記上側ジョーに係合した遠位クロージャ管部分(116)を含み、
前記クロージャスリーブ組立体の前記近位クロージャ部材は、前記取っ手部分に結合された近位クロージャ管部分(52)を含み、
前記クロージャスリーブ組立体の前記少なくとも1つのリンクは、上側二重ピボットリンク(134)および下側二重ピボットリンク(140)を含み、これらピボットリンクの各々の両端部がそれぞれ、前記遠位クロージャ管部分および前記近位クロージャ管部分に回動自在に取り付けられている、外科用器械。 - 請求項2記載の外科用器械において、
前記遠位クロージャ管部分は、近位側へ差し向けられたクレビス(126,128)および前記クレビスに取り付けられた第1の円筒形部材(148)を更に含み、
前記近位クロージャ管部分は、遠位側へ差し向けられたクレビス(119,120)および前記クレビスに取り付けられた第2の円筒形部材(152)を更に含む、外科用器械。 - 請求項1記載の外科用器械において、
前記フレーム組立体は、
一端が前記遠位フレーム部分および前記近位フレーム部分のうちの選択された一方に剛性的に取り付けられるとともに他端が前記遠位フレーム部分および前記近位フレーム部分のうちの他方に回動自在に取り付けられたフレーム回動アーム(160)、
を更に含む、外科用器械。 - 請求項4記載の外科用器械において、
前記フレーム回動アームは、発火バーを案内するナイフスロット(163)を含む、外科用器械。 - 請求項1記載の外科用器械において、
前記下側ジョーは、ステープルカートリッジを収容する細長いチャネル(40)を含み、
前記回動自在に取り付けられた上側ジョーは、ステープル形成面を備えたアンビル(42)を含む、外科用器械。 - 請求項1記載の外科用器械において、
前記遠位フレーム部分および前記近位フレーム部分は、他方に互いにオーバーラップした状態で回動自在に取り付けられた端部を提供する、外科用器械。 - 外科用器械において、
細長いチャネル(40)と、前記細長いチャネル内に嵌め込まれたステープルカートリッジ(178)と、前記細長いチャネルに回動自在に取り付けられ、前記ステープルカートリッジに対してステープル形成面を提供するアンビル(42)と、を備えるステープル留め組立体と、
フレーム組立体(44)および前記フレーム組立体を長手方向に摺動自在に包囲するクロージャスリーブ組立体(46;2424)を備える細長いシャフト(16)であって、前記フレーム組立体は、前記細長いチャネルに取り付けられた遠位フレーム部分(114)および前記遠位フレーム部分に関節運動継手によって回動自在に取り付けられた近位フレーム部分(48)を備える、細長いシャフトと、
前記近位フレーム部分の近位端部に取り付けられていて、閉鎖運動を前記クロージャスリーブ組立体に長手方向に結合するよう作動的に構成された取っ手部分(22)と、
を具備し、
前記関節運動継手は第1のピボット点を定め、前記第1のピボット点周りで前記遠位フレーム部分が前記近位フレーム部分に対して回動可能であり、
前記クロージャスリーブ組立体は、
前記関節運動継手を包囲し、前記アンビルの回動を引き起こすよう前記アンビルに遠位側で係合し、複数のピボット点を有するピボット継手、
を含み、
前記クロージャスリーブ組立体は、
遠位クロージャ部材と、
近位クロージャ部材と、
を更に含み、
前記クロージャスリーブ組立体の前記ピボット継手は、前記近位クロージャ部材を前記遠位クロージャ部材に連結する少なくとも1つのリンクを含み、前記少なくとも1つのリンクは第2のピボット点および第3のピボット点を定め、前記遠位クロージャ部材は、前記第2のピボット点周り、および前記第3のピボット点周りで、前記近位クロージャ部材に対して回動可能である、外科用器械。 - 請求項8記載の外科用器械において、
前記クロージャスリーブ組立体の前記遠位クロージャ部材は、前記アンビルに係合した遠位クロージャ管部分(116)を含み、
前記クロージャスリーブ組立体の前記近位クロージャ部材は、前記取っ手部分に結合された近位クロージャ管部分(52)を含み、
前記クロージャスリーブ組立体の前記少なくとも1つのリンクは、上側二重ピボットリンク(134)および下側二重ピボットリンク(140)を含み、これらピボットリンクの各々の両端部がそれぞれ、前記遠位クロージャ管部分および前記近位クロージャ管部分に回動自在に取り付けられている、外科用器械。 - 請求項9記載の外科用器械において、
前記遠位クロージャ管部分は、近位側へ差し向けられたクレビス(126,128)および前記クレビスに取り付けられた第1の円筒形部材(148)を更に含み、
前記近位クロージャ管部分は、遠位側へ差し向けられたクレビス(119,120)および前記クレビスに取り付けられた第2の円筒形部材(152)を更に含む、外科用器械。 - 請求項8記載の外科用器械において、
前記フレーム組立体は、
一端が前記遠位フレーム部分および前記近位フレーム部分のうちの選択された一方に剛性的に取り付けられるとともに他端が前記遠位フレーム部分および前記近位フレーム部分のうちの他方に回動自在に取り付けられたフレーム回動アーム(160)、
を更に含む、外科用器械。 - 請求項11記載の外科用器械において、
前記フレーム回動アームは、発火バーを案内するナイフスロット(163)を含む、外科用器械。 - 請求項8記載の外科用器械において、
前記遠位フレーム部分および前記近位フレーム部分は、他方に互いにオーバーラップした状態で回動自在に取り付けられた端部を提供する、外科用器械。
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US11/165,468 US20060289602A1 (en) | 2005-06-23 | 2005-06-23 | Surgical instrument with articulating shaft with double pivot closure and single pivot frame ground |
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JP (1) | JP5179024B2 (ja) |
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- 2006-05-30 SG SG200603611A patent/SG128563A1/en unknown
- 2006-06-19 CN CN2006100930523A patent/CN1883411B/zh active Active
- 2006-06-20 CA CA002550548A patent/CA2550548A1/en not_active Abandoned
- 2006-06-22 EP EP06253226A patent/EP1736105A1/en not_active Withdrawn
- 2006-06-22 KR KR1020060056238A patent/KR20060134840A/ko not_active Application Discontinuation
- 2006-06-22 JP JP2006172905A patent/JP5179024B2/ja active Active
- 2006-06-22 MX MXPA06007225A patent/MXPA06007225A/es unknown
- 2006-06-23 BR BRPI0602333-9A patent/BRPI0602333A/pt not_active IP Right Cessation
Also Published As
Publication number | Publication date |
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JP2007000633A (ja) | 2007-01-11 |
MXPA06007225A (es) | 2007-01-10 |
CN1883411B (zh) | 2012-09-26 |
KR20060134840A (ko) | 2006-12-28 |
EP1736105A1 (en) | 2006-12-27 |
IL175761A0 (en) | 2006-10-05 |
CN1883411A (zh) | 2006-12-27 |
AU2006202051A1 (en) | 2007-01-11 |
SG128563A1 (en) | 2007-01-30 |
CA2550548A1 (en) | 2006-12-23 |
US20060289602A1 (en) | 2006-12-28 |
AU2006202051B2 (en) | 2012-06-14 |
BRPI0602333A (pt) | 2007-02-21 |
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