JP5265089B2 - 外科用クリップ前進・位置決め機構 - Google Patents
外科用クリップ前進・位置決め機構 Download PDFInfo
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Description
この発明は、広く外科装置に関するものであり、より詳細には、導管、血管、吻合部(shunts)等に外科用クリップを取り付ける方法および装置に関するものである。
近年、外科手術は、胆嚢摘出術、胃瘻造設術、虫垂切除術およびヘルニア修復術等の腹腔鏡検査的かつ内視鏡検査的な外科手法の実績を通じて著しく進歩してきている。これらの手法は、体腔に穿刺して使用される外科器具であるトロカールアセンブリを通じて達成される。上記トロカールは、典型的には、鋭利な先端部を有する栓塞子とトロカールチューブすなわちカニューレを含むものである。トロカールカニューレは、皮膚を貫通する先端部を有する栓塞子を用いて、皮膚内に挿入されて体腔に到達するものである。貫通後に、栓塞子は取り外されるが、上記トロカールカニューレは体内に残る。外科器具は、上記トロカールカニューレを通じて配置される。
この発明は、導管、血管、吻合部等に外科用クリップを取り付ける方法および装置を提供するものである。1つの例示的な実施の形態では、外科用クリップ取付具には、ハウジングであって、このハウジングに動作可能に接続されたトリガーを有するハウジングと、このハウジングから延在する長尺シャフトであって、この長尺シャフトの遠位端上に形成され、互いに対向する顎部を有する長尺シャフトとが備えられている。上記トリガーは、クリップを前進させて上記顎部間に上記クリップを位置決めすると共に、上記顎部を開位置から閉位置へ移動させて上記顎部間に位置決めされた上記クリップを加締めるように構成されている。
この発明は、概ね、外科手術中に、血管、導管、吻合部等に外科用クリップを取り付けるための外科用クリップ取付具およびこの取付具を用いる方法を提供するものである。例示的な外科用クリップ取付具は、この明細書に記述され、かつ図面に示されているように、外科用クリップの取付を容易にする種々の態様を含めることができる。しかしながら、この技術分野における当業者は、上記外科用クリップ取付具が上記態様の一部のみを含めることができ、および/またはこの技術分野において公知である他の種々の態様を含めることができるものと正当に評価するはずである。この明細書に記述された外科用クリップ取付具は、特定の例示的な実施の形態を表そうとしているに過ぎないものである。
(1)外科用クリップ取付具において、
該握りハウジングに連結されたトリガーを有する握りハウジングと、
前記握りハウジングから延在する長尺シャフトであって、該長尺シャフトの遠位端上に形成され、かつ開位置と閉位置との間で移動可能な互いに対向する顎部を有する、長尺シャフトと、
前記長尺シャフト内に配されたクリップ前進アセンブリであって、前記長尺シャフトを通じて少なくとも1つのクリップを前進させ、前記顎部間に1つのクリップを位置決めするための、クリップ前進アセンブリと、
前記握りハウジング内に配された可撓性のリンク機構であって、前記トリガーからの動きを前記クリップ前進アセンブリへ伝えて、前記クリップ前進アセンブリが前記トリガーの移動に応答して少なくとも1つのクリップを前進させるように構成された、可撓性のリンク機構と、
を含む、外科用クリップ取付具。
(2)実施態様1記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、前記握りハウジング内に旋回可能に配され、かつ前記クリップ前進アセンブリと、前記トリガーに連結されたトリガー挿入部との間に延在する、外科用クリップ取付具。
(3)実施態様2記載の外科用クリップ取付具において、
前記クリップ前進アセンブリは、前記長尺シャフトを通じて延在するフィードバーであって、前記長尺シャフトを通じて少なくとも1つのクリップを遠位側へ前進させるように構成された遠位端と、前記可撓性のリンク機構の一部分を受け入れるためのフィードバーカプラーに連結された近位端とを有するフィードバーを含む、外科用クリップ取付具。
(4)実施態様3記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、前記フィードバーカプラー内に形成された凹部内に受け入れられるように構成された第1の端部と、前記トリガー挿入部内に形成された凹部内に受け入れられるように構成された第2の端部とを含む、外科用クリップ取付具。
(5)実施態様4記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、前記第1および前記第2の端部間に配された横軸であって、前記第1および前記第2の端部間に延在する長軸に対して実質的に直交する方向に延在する横軸回りに旋回するように構成されている、外科用クリップ取付具。
(6)実施態様1記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、前記トリガーが閉位置に向かって移動するときに、撓むように構成されている、外科用クリップ取付具。
(7)実施態様1記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、ポリマーから構成されている、外科用クリップ取付具。
(8)実施態様1記載の外科用クリップ取付具において、
前記可撓性のリンク機構は、金属から構成されている、外科用クリップ取付具。
(9)外科用クリップ取付具と共に使用されるクリップ前進アセンブリにおいて、
外科用クリップ取付具の長尺シャフト内に配されるように構成されたクリップ前進シャフトであって、前記クリップ前進シャフトの遠位側への移動時に、少なくとも1つのクリップを前進させるように構成されたクリップ前進シャフトと、
外科用クリップ取付具のハウジング内に配されるように構成されたトリガー挿入部であって、前記トリガーの移動が前記トリガー挿入部を移動させるのに有効であるように前記ハウジングに対して移動可能なトリガーに連結されるように構成されたトリガー挿入部と、
前記ハウジング内に旋回可能に配されるように構成された可撓性のリンク機構であって、前記トリガー挿入部の移動が、前記可撓性のリンク機構を旋回させ、これにより前記クリップ前進シャフトを遠位側へ移動させるように、前記トリガー挿入部と前記クリップ前進シャフトとの間に延在するように構成された可撓性のリンク機構と、
を含む、クリップ前進アセンブリ。
(10)実施態様9記載のクリップ前進アセンブリにおいて、
前記クリップ前進シャフトは、前記可撓性のリンク機構に連結されるように構成された近位端を有するフィードバーを有している、クリップ前進アセンブリ。
(11)実施態様10記載のクリップ前進アセンブリにおいて、
前記フィードバーの前記近位端は、前記可撓性のリンク機構に連結するためのカプラーを含む、クリップ前進アセンブリ。
(12)実施態様11記載のクリップ前進アセンブリにおいて、
前記カプラーは、互いに対向する環状のフランジを含み、該フランジは、これら両フランジ間に、前記可撓性のリンク機構の一部分を配置するための環状の溝を画定する、クリップ前進アセンブリ。
(13)実施態様12記載のクリップ前進アセンブリにおいて、
前記可撓性のリンク機構は、前記環状の溝内に受け入れられるように構成され、互いに対向するアームを含む、クリップ前進アセンブリ。
(14)実施態様9記載のクリップ前進アセンブリにおいて、
前記トリガー挿入部は、該トリガー挿入部内に形成され、かつ前記可撓性のリンク機構の一部分を受け入れるための凹部を含む、クリップ前進アセンブリ。
(15)実施態様9記載のクリップ前進アセンブリにおいて、
前記可撓性のリンク機構は、互いに対向する第1の端部と第2の端部との間に配され、かつ前記第1の端部と前記第2の端部との間に延在する長軸に実質的に直交する方向に延在する横軸回りに旋回するように構成されている、クリップ前進アセンブリ。
(16)実施態様15記載のクリップ前進アセンブリにおいて、
前記第1の端部は、前記クリップ前進シャフトに連結するように構成され、前記第2の端部は、前記トリガー挿入部に連結するように構成され、前記横軸は、前記第2の端部の実質的に近傍の位置に配されている、クリップ前進アセンブリ。
(17)外科用クリップ取付具において、
トリガーに連結されたクリップ前進アセンブリであって、ハウジングから延在する長尺シャフトを通じて少なくとも1つのクリップを前進させるように構成されたクリップ前進アセンブリと、
トリガーに連結されたクリップ成形アセンブリであって、前記長尺シャフトの遠位端上に形成された顎部アセンブリを作動して外科用クリップを形成するように構成されたクリップ成形アセンブリと、
前記ハウジングに連結され、かつ前記クリップ前進アセンブリおよび前記クリップ形成アセンブリを作動させるように構成されたトリガーであって、連続した2つの作動段階を有し、第1の作動段階中に、前記クリップ前進アセンブリを作動させるのに有効であり、第2の作動段階中に、前記クリップ形成アセンブリを作動させ、かつ前記クリップ前進アセンブリに適応するのに有効である、トリガーと、
を含む、外科用クリップ取付具。
(18)実施態様17記載の外科用クリップ取付具において、
前記トリガーおよび前記クリップ前進アセンブリは、可撓性のリンク機構によって連結されている、外科用クリップ取付具。
(19)実施態様18記載の外科用クリップ取付具において、
前記トリガーと前記可撓性のリンク機構との間に連結されたトリガー挿入部であって、前記第1および前記第2の作動段階中に、前記トリガーと共に旋回するように構成されたトリガー挿入部をさらに含む、外科用クリップ取付具。
(20)実施態様19記載の外科用クリップ取付具において、
前記トリガー挿入部は、前記可撓性のリンク機構を前記第1の作動段階中に旋回させ、かつ撓ませるように構成されると共に、前記トリガー挿入部は、前記第2の作動段階中に前記可撓性のリンク機構を曲げた位置に維持するように構成されている、外科用クリップ取付具。
(21)外科用クリップ取付具における外科用クリップを前進させる方法において、
ハウジングに連結されたトリガーを閉位置に移動させ、前記ハウジング内に配された可撓性のリンク機構を旋回させ、かつ前記ハウジングから延在する長尺シャフト内に配されたクリップ前進アセンブリを遠位側へ前進させ、少なくとも、前記長尺シャフトの遠位端上に形成され、互いに対向する顎部内へのクリップの前進を開始させるステップと、
前記トリガーを前記閉位置に向けてさらに移動させ、クリップ形成アセンブリが遠位側へ前進して、前記長尺シャフトの遠位端上に形成された互いに対向する顎部を閉じさせ、これにより前記顎部間に位置決めされたクリップを閉じると同時に、実質的に固定した位置に前記クリップ前進アセンブリが維持されるように、前記可撓性のリンク機構を撓ませるステップとを含む、方法。
(22)実施態様21記載の方法において、
前記トリガーを開位置に緩め、前記可撓性のリンク機構を、反対方向に旋回させ、かつ前記クリップ前進アセンブリを近位側へ後退させるステップをさらに含む、方法。
(23)実施態様21記載の方法において、
前記可撓性のリンク機構は、前記トリガーに連結されたトリガー挿入部と前記クリップ前進アセンブリとの間に延在する、方法。
(24)実施態様23記載の方法において、
前記トリガーの移動は、前記トリガー挿入部を旋回させ、これにより前記可撓性のリンク機構を旋回させる、方法。
(25)実施態様23記載の方法において、
前記クリップ前進アセンブリは、フィードバーを含み、該フィードバーは、該フィードバーの近位端上に形成され、かつ前記フィードリンク機構に連結されたカプラー部材を有している、方法。
Claims (20)
- 外科用クリップ取付具において、
握りハウジングであって、この握りハウジングに連結されたトリガーを有する、握りハウジングと、
前記握りハウジングから延在する長尺シャフトであって、この長尺シャフトの遠位端上に形成され、かつ開位置と閉位置との間で移動可能な互いに対向する顎部を有する、長尺シャフトと、
前記長尺シャフト内に配されたクリップ前進アセンブリであって、前記長尺シャフトを通じて少なくとも1つのクリップを前進させ、前記対向する顎部間に1つのクリップを位置決めするための、クリップ前進アセンブリと、
前記握りハウジング内に旋回可能に配された可撓性のリンク部材であって、前記トリガーからの動きを前記クリップ前進アセンブリへ伝えて、前記クリップ前進アセンブリが前記トリガーの移動に応答して少なくとも1つのクリップを前進させるように構成された、可撓性のリンク部材と、
を含み、
前記トリガーは、連続した2つの作動段階を有し、前記トリガーは、第1の作動段階中に、前記可撓性のリンク部材を撓ませることなく前記可撓性のリンク部材を旋回させるように構成されていて、前記クリップ前進アセンブリを作動させるのに有効であり、前記トリガーは、第2の作動段階中に、前記可撓性のリンク部材を撓ませるように構成されていて、前記クリップ前進アセンブリに適応したままでクリップ形成アセンブリを作動させるのに有効である、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、前記クリップ前進アセンブリと、前記トリガーに連結されたトリガー挿入部との間に延在する、外科用クリップ取付具。 - 請求項2記載の外科用クリップ取付具において、
前記クリップ前進アセンブリは、前記長尺シャフトを通じて延在するフィードバーであって、前記長尺シャフトを通じて少なくとも1つのクリップを遠位側へ前進させるように構成された遠位端と、前記可撓性のリンク部材の一部分を受け入れるためのフィードバーカプラーに連結された近位端とを有するフィードバーを含む、外科用クリップ取付具。 - 請求項3記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、前記フィードバーカプラー内に形成された凹部内に受け入れられるように構成された第1の端部と、前記トリガー挿入部内に形成された凹部内に受け入れられるように構成された第2の端部とを含む、外科用クリップ取付具。 - 請求項4記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、前記第1および前記第2の端部間に配された横軸であって、前記第1および前記第2の端部間に延在する長軸に対して実質的に直交する方向に延在する横軸回りに旋回するように構成されている、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、前記トリガーが閉位置に向かって移動するときに、撓むように構成されている、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、ポリマーから構成されている、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、金属から構成されている、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記クリップ前進アセンブリは、
前記長尺シャフト内に配されるように構成されたクリップ前進シャフトであって、前記クリップ前進シャフトの遠位側への移動時に、少なくとも1つのクリップを前進させるように構成された、クリップ前進シャフトと、
前記握りハウジング内に配されるように構成されたトリガー挿入部であって、前記トリガーの移動が前記トリガー挿入部を移動させるのに有効であるように前記ハウジングに対して移動可能な前記トリガーに連結されるように構成された、トリガー挿入部と、
を含み、
前記可撓性のリンク部材は、前記トリガー挿入部の移動が、前記可撓性のリンク部材を旋回させ、これにより前記クリップ前進シャフトを遠位側へ移動させるのに有効であるように、前記トリガー挿入部と前記クリップ前進シャフトとの間に延在するように構成されている、
外科用クリップ取付具。 - 請求項9記載の外科用クリップ取付具において、
前記クリップ前進シャフトは、前記可撓性のリンク部材に連結されるように構成された近位端を有するフィードバーを備えている、外科用クリップ取付具。 - 請求項10記載の外科用クリップ取付具において、
前記フィードバーの前記近位端は、前記可撓性のリンク部材に連結するためのカプラーを含む、外科用クリップ取付具。 - 請求項11記載の外科用クリップ取付具において、
前記カプラーは、互いに対向する環状のフランジを含み、これらフランジは、これら両フランジ間に、前記可撓性のリンク部材の一部分を配置するための環状の溝を画定する、外科用クリップ取付具。 - 請求項12記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、前記環状の溝内に受け入れられるように構成され、互いに対向するアームを含む、外科用クリップ取付具。 - 請求項9記載の外科用クリップ取付具において、
前記トリガー挿入部は、このトリガー挿入部内に形成され、かつ前記可撓性のリンク部材の一部分を受け入れるための凹部を含む、外科用クリップ取付具。 - 請求項9記載の外科用クリップ取付具において、
前記可撓性のリンク部材は、互いに対向する第1の端部と第2の端部との間に配され、かつ前記第1の端部と前記第2の端部との間に延在する長軸に実質的に直交する方向に延在する横軸回りに旋回するように構成されている、外科用クリップ取付具。 - 請求項15記載の外科用クリップ取付具において、
前記第1の端部は、前記クリップ前進シャフトに連結するように構成され、前記第2の端部は、前記トリガー挿入部に連結するように構成され、前記横軸は、前記第2の端部の実質的に近傍の位置に配されている、外科用クリップ取付具。 - 請求項1記載の外科用クリップ取付具において、
前記長尺シャフトの遠位端上に形成された前記顎部を作動して外科用クリップを形成するように構成されたクリップ成形アセンブリ、
をさらに含む、外科用クリップ取付具。 - 請求項17記載の外科用クリップ取付具において、
前記トリガーおよび前記クリップ前進アセンブリは、前記可撓性のリンク部材によって連結されている、外科用クリップ取付具。 - 請求項18記載の外科用クリップ取付具において、
前記トリガーと前記可撓性のリンク部材との間に連結されたトリガー挿入部であって、前記第1および第2の作動段階中に、前記トリガーと共に旋回するように構成されたトリガー挿入部をさらに含む、外科用クリップ取付具。 - 請求項19記載の外科用クリップ取付具において、
前記トリガー挿入部は、前記第1の作動段階中に前記可撓性のリンク部材を旋回させ、かつ撓ませるように構成され、前記トリガー挿入部は、前記第2の作動段階中に前記可撓性のリンク部材を撓んだ位置に維持するように構成されている、外科用クリップ取付具。
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US10/907,768 US7731724B2 (en) | 2005-04-14 | 2005-04-14 | Surgical clip advancement and alignment mechanism |
US10/907,768 | 2005-04-14 |
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CN (1) | CN100522080C (ja) |
AU (1) | AU2006201349B2 (ja) |
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2005
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- 2006-03-31 AU AU2006201349A patent/AU2006201349B2/en not_active Ceased
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US20060235441A1 (en) | 2006-10-19 |
BRPI0601358B8 (pt) | 2023-02-23 |
CA2543563A1 (en) | 2006-10-14 |
EP2263570B1 (en) | 2014-02-26 |
EP1712188A2 (en) | 2006-10-18 |
BRPI0601358A (pt) | 2006-12-26 |
CA2543563C (en) | 2014-09-09 |
AU2006201349A1 (en) | 2006-11-02 |
EP1712188A3 (en) | 2007-01-24 |
CN100522080C (zh) | 2009-08-05 |
CN1846637A (zh) | 2006-10-18 |
BRPI0601358B1 (pt) | 2018-02-06 |
AU2006201349B2 (en) | 2012-05-24 |
KR101296695B1 (ko) | 2013-08-19 |
JP2006289103A (ja) | 2006-10-26 |
ES2387894T3 (es) | 2012-10-03 |
BRPI0601358A8 (pt) | 2018-05-15 |
US7731724B2 (en) | 2010-06-08 |
EP2263570A1 (en) | 2010-12-22 |
KR20060108563A (ko) | 2006-10-18 |
SG126856A1 (en) | 2006-11-29 |
EP1712188B1 (en) | 2012-06-20 |
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