JP5306608B2 - 複数のステープルサイズを有するカートリッジを含む外科用ステープル留め器具 - Google Patents
複数のステープルサイズを有するカートリッジを含む外科用ステープル留め器具 Download PDFInfo
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- 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
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- 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
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- A—HUMAN NECESSITIES
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- A61B17/1114—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis of the digestive tract, e.g. bowels or oesophagus
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- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B2017/07235—Stapler heads containing different staples, e.g. staples of different shapes, sizes or materials
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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
- A61B2017/07242—Stapler heads achieving different staple heights during the same shot, e.g. using an anvil anvil having different heights or staples of different sizes
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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
- A61B2017/0725—Stapler heads with settable gap between anvil and cartridge, e.g. for different staple heights at different shots
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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
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- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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Description
本出願は、2005年8月15日に出願された同時係属中の米国特許出願番号第11/204、060号の一部継続出願であり、その全体の内容は、本明細書中に参考として本明細書によって援用される。
1.技術分野
本開示は、外科用ステープル留め器具、そしてより詳細には、複数のステープルサイズを有するカートリッジを含む外科用ステープル留め器具に関する。
2.関連技術の背景
端と端とを接した吻合、胃腸管吻合、内視鏡胃腸管吻合、および横断吻合のような種々の手順における使用のために特別に適合されたいくつかの公知のタイプの外科用ステープル留めデバイスがある。これらの種々の手順のためのステープル留め器具の例は、特許文献1;特許文献2;特許文献3;および特許文献4に見出され得る。
本開示は、組織界面における吻合強度と止血の程度との間の改良されたバランスを達成するような形態の外科用ステープル留め器具に関する。特に、本開示の実施形態は、異なるサイズの外科用ファスナーを含む。さらになお、アンビル部材とステープルカートリッジとの間の距離(すなわち、ギャップ)は、ステープルカートリッジの中央線からステープルカートリッジの外側エッジまで変動する。好ましくは、このギャップは、上記中央線におけるギャップと比較して上記カートリッジの外側エッジでより大きい。これは、ステープルカートリッジおよび/またはアンビル部材のいずれかの輪郭(すなわち、プロフィール)を変動することによって達成され得る。異なるサイズの外科用ファスナーを、アンビル部材とステープルカートリッジとの間の変動するギャップと組み合わせることは、組織界面における吻合強度および止血の程度を改良する。
(項目1)外科用ステープル留め装置のためのステープルカートリッジであって:
第1の壁および第2の壁を有する本体部分;および
それを通って延びる水平面を有する組織接触面であって、上記水平面が、上記本体部分を通って延びる垂直軸を実質的に横断する組織接触面を備え、ここで、上記組織接触面および上記水平面の点がそれらの間のギャップを規定し、上記ギャップが、上記寸法を規定する点が、上記垂直軸に対して横方向に移動するとき変化する、ステープルカートリッジ。
内壁および外壁であって、上記内壁が上記外壁の高さに等しくない高さを有する内壁および外壁;
第1の側面、第2の側面、第1の複数の保持スロット、および平面軸を有する第1の表面であって、上記平面軸が上記内壁に対して直角を規定する第1の表面;
第1の側面、第2の側面、および第2の複数の保持スロットを有する第2の表面であって、上記第2の表面の第1の側面が上記第1の表面の第2の側面に連結され、そして上記第2の表面の第2の側面が上記外壁の上部エッジに連結されて上記内壁と外壁との間の上記第2の表面に沿って弓状経路を規定する第2の表面;および
上記第1および第2の複数の保持スロット中にそれぞれ配置される第1および第2の複数の外科用ファスナーであって、バックスパンおよび一対の脚を含み、上記第1の複数の外科用ファスナーが第1の脚長さを有し、上記第2の複数の外科用ファスナーが第2の脚長さを有し、そして上記第2の脚長さが上記第1の脚長さとは異なる第1および第2の複数の外科用ファスナーを備える、ステープルカートリッジ。
以下を備える外科用ステープル留め装置のためのステープルカートリッジ:
第1の複数の保持スロットおよび第1の平面軸を有する第1の表面であって、第1の側面および第2の側面を含む第1の表面;
第1の側面、第2の側面、および第2の複数の保持スロットを有する第2の表面であって、上記第2の表面の第1の側面が上記第1の表面の第2の側面に連結され、そして上記第2の表面の第2の側面が外壁の上部エッジに連結され、上記第2の表面に沿って内壁と上記外壁との間で弓状経路を規定する第2の表面;
上記第1および第2の複数の保持スロットにそれぞれ配置される第1および第2の複数の外科用ファスナーであって、バックスパンおよび一対の脚を含み、上記第1の複数の外科用ファスナーが第1の脚長さを有し、上記第2の複数の外科用ファスナーが第2の脚長さを有し、上記第2の脚長さが上記第1の脚長さとは異なる第1および第2の複数の外科用ファスナー;ならびに
上記ステープルカートリッジに対して位置決め可能なアンビル部材であって、そして上記アンビルと上記ステープルカートリッジとの間に配置される複数の異なるギャップを、上記アンビル部材が上記ステープルカートリッジの近位方向にあるとき、上記ステープルカートリッジの第1の表面と上記アンビルとの間の第1のギャップが、上記ステープルカートリッジの第2の表面と上記アンビルとの間の第2のギャップより小さいように規定するアンビル部材、を備える、外科用ステープル装置。
鉛直部材;
複数の保持スロットおよび第1の平面軸を有する第1の平面状表面であって、上記鉛直部材に取り付けられた第1の側面を含む第1の平面状表面;
複数の開口部および第2の平面軸を有する第2の平面状表面であって、第1の側面および第2の側面を含み、上記第1の側面が上記鉛直部材に柔軟に取り付けられ、そして第1の位置でそれらの間に直交する角度を規定し、上記第2の平面状表面が上記第1の平面状表面から離れて間隔を置かれてそれらの間にギャップを規定し、ここで、上記第2の平面状表面の第2の側面の上記第1の平面状表面に向かう移動が、上記第2の平面状表面を曲げる第2の平面状表面;ならびに
上記第1の複数の保持スロット中に配置される複数の外科用ファスナーであって、バックスパンおよび一対の脚を含む複数の外科用ファスナー、を備える、ステープルカートリッジ。
第1の組織接触表面を有するアンビル部材;および
第1の壁、第2の壁、および第2の組織接触表面を有する本体部分、を備え、
ここで、上記第1の組織接触表面および上記第2の組織接触表面がそれらの間にギャップを規定し、そして上記ギャップが、上記第1または第2の組織接触表面の少なくとも1つによって規定される水平平面に沿って変動する、外科用ステープル留め装置。
現在開示される外科用ステープル留め器具の実施形態は、ここで、描写される図面を参照して詳細に説明され、ここで、同様の参照番号は、類似または同一の要素を識別する。以下の図面および説明では、用語「近位」は、伝統的なように、操作者に最も近い外科用ステープル留め器具の端部をいい、その一方、用語「遠位」は、操作者から最も遠いデバイスの端部をいう。
外科用ステープル留め装置は、ステープルカートリッジおよびアンビル部材を含む。このステープルカートリッジは、保持スロットの列中に配置される複数の外科用ファスナーを含む。このステープルカートリッジは、保持スロットの環状または直線状形態を有し得る。このステープルカートリッジの組織接触表面は、テーパー状であるか、または階段状であり得る。アンビル部材は、上記保持スロットと実質的に整列するために整列された多くのポケットを含む組織接触表面を有する。さらに、上記アンビル部材の組織接触表面は、上記ステープルカートリッジの組織接触表面を相補し得る。
27 ステープルのバックスパン
50 創傷閉鎖アセンブリ
52 リザーバー
54 供給ライン
56 開口部
100、200、300、400 外科用ステープル留め装置
102 ハンドルアセンブリ
103 ハンドル部材
104 管状本体部分
106
108 アンビルアセンブリ
109 アンビルヘッド
110 アンビルシャフト
118 ステープルカートリッジ
121 組織接触表面
123 保持スロット
125 ステープル
130 ファスナー射出部材
138 ドライバーチューブ
408 アンビル部材
420 組織接触表面
425 ポケット
Claims (14)
- 外科用ステープル留め装置のためのステープルカートリッジであって:
第1の壁および第2の壁を有する本体部分;および
それを通って延びる水平面を有する組織接触面であって、該水平面が、該本体部分を通って延びる垂直軸を実質的に横断し、ここで、該組織接触面と該水平面上の点とがそれらの間にギャップを規定し、該ギャップが、該寸法を規定する点が該垂直軸に対して横方向に移動するとき変化する組織接触面;第1の脚長さを有する第1の複数の外科用ファスナー;および第2の脚長さを有する第2の複数の外科用ファスナーを備え、該第1の脚長さが該第2の脚長さより短く、
該組織接触面が階段状の形態を有し、該第1の複数の外科用ファスナーが第1のギャップに合い、そして該第2の複数の外科用ファスナーが第2のギャップに合い、該第1のギャップが該第2のギャップより小さい、ステープルカートリッジ。 - 前記組織接触表面が、第1の部分および第2の部分を含む、請求項1に記載のステープルカートリッジ。
- 前記寸法を規定する点の前記本体部分の中央線から前記第1の壁に向かう移動が、増加するギャップを規定する、請求項2に記載のステープルカートリッジ。
- 前記中央線に沿って配置されたナイフをさらに含む、請求項3に記載のステープルカートリッジ。
- 外科用ステープル留め装置のためのステープルカートリッジであって:
内壁および外壁であって、該内壁が該外壁の高さに等しくない高さを有する内壁および外壁;
第1の側面、第2の側面、第1の複数の保持スロット、および平面軸を有する第1の表面であって、該平面軸が該内壁に対して直角を規定する第1の表面;
第1の側面、第2の側面、および第2の複数の保持スロットを有する第2の表面であって、該第2の表面の第1の側面が該第1の表面の第2の側面に連結され、そして該第2の表面の第2の側面が該外壁の上部エッジに連結されて該内壁と外壁との間の該第2の表面に沿って弓状経路を規定する第2の表面;および
該第1および第2の複数の保持スロット中にそれぞれ配置される第1および第2の複数の外科用ファスナーであって、バックスパンおよび一対の脚を含み、該第1の複数の外科用ファスナーが第1の脚長さを有し、該第2の複数の外科用ファスナーが第2の脚長さを有し、そして該第2の脚長さが該第1の脚長さより長い第1および第2の複数の外科用ファスナーを備え、該第1の複数の外科用ファスナーが第1のギャップに合い、そして該第2の複数の外科用ファスナーが第2のギャップに合い、該第1のギャップが該第2のギャップより小さい、ステープルカートリッジ。 - 前記第1の複数の保持スロット中に配置される前記外科用ファスナーのバックスパンが、前記第1の表面の前記平面軸に実質的に平行である、請求項5に記載のステープルカートリッジ。
- 第3の複数の保持スロット中に配置された第3の複数の外科用ファスナーをさらに含み、該第3の複数の外科用ファスナーが、前記第1の脚長さとは異なる第3の脚長さを有する、請求項5に記載のステープルカートリッジ。
- 外科用ステープル留め装置であって:
以下を備える外科用ステープル留め装置のためのステープルカートリッジ:
第1の複数の保持スロットおよび第1の平面軸を有する第1の表面であって、第1の側面および第2の側面を含む第1の表面;
第1の側面、第2の側面、および第2の複数の保持スロットを有する第2の表面であって、該第2の表面の第1の側面が該第1の表面の第2の側面に連結され、そして該第2の表面の第2の側面が外壁の上部エッジに連結され、該第2の表面に沿って内壁と該外壁との間で弓状経路を規定する第2の表面;
該第1および第2の複数の保持スロットにそれぞれ配置される第1および第2の複数の外科用ファスナーであって、バックスパンおよび一対の脚を含み、該第1の複数の外科用ファスナーが第1の脚長さを有し、該第2の複数の外科用ファスナーが第2の脚長さを有し、該第2の脚長さが該第1の脚長さより長い第1および第2の複数の外科用ファスナー;ならびに
該ステープルカートリッジに対して位置決め可能なアンビル部材であって、そして該アンビルと該ステープルカートリッジとの間に配置される複数の異なるギャップを、該アンビル部材が該ステープルカートリッジの近位方向にあるとき、該ステープルカートリッジの第1の表面と該アンビルとの間の第1のギャップが、該ステープルカートリッジの第2の表面と該アンビルとの間の第2のギャップより小さいように規定するアンビル部材、を備え、該第1の複数の外科用ファスナーが第1のギャップに合い、そして該第2の複数の外科用ファスナーが第2のギャップに合い、該第1のギャップが該第2のギャップより小さい、外科用ステープル留め装置。 - 前記アンビル部材が、平面状組織接触表面を含む、請求項8に記載の外科用ステープル留め装置。
- 前記アンビル部材が複数の表面を含み、該複数の表面が平面状表面および少なくとも1つの弓状表面を含み、該平面状表面が前記ステープルカートリッジの第1の表面の幅寸法に少なくとも等しい幅寸法を有し、そして該少なくとも1つの弓状表面が該ステープルカートリッジの第2の表面の湾曲に対応する湾曲を有する、請求項8に記載の外科用ステープル留め装置。
- 外科用ステープル留め装置であって:
第1の組織接触表面を有するアンビル部材;および
第1の壁、第2の壁、および第2の組織接触表面を有する本体部分であって、ここで、該第1の組織接触表面と該第2の組織接触表面とがそれらの間にギャップを規定し、そして該ギャップが、該第1または第2の組織接触表面の少なくとも1つによって規定される水平平面に沿って変動する本体部分;第1の脚長さを有する第1の複数の外科用ファスナー;および第2の脚長さを有する第2の複数の外科用ファスナーを備え、該第1の脚長さが該第2の脚長さより短く、該第1の組織接触面および該第2の組織接触面が階段状の形態を有し、該第1の複数の外科用ファスナーが第1のギャップに合い、そして該第2の複数の外科用ファスナーが第2のギャップに合い、該第1のギャップが該第2のギャップより小さい、外科用ステープル留め装置。 - 前記第2の組織接触表面が、第1の部分および第2の部分を含む、請求項11に記載の外科用ステープル留め装置。
- 前記本体部分の中央線における前記ギャップが、前記第1の壁における前記ギャップより小さい、請求項12に記載の外科用ステープル留め装置。
- 前記中央線に沿って配置されるナイフをさらに含む、請求項13に記載の外科用ステープル留め装置。
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US11/436,222 US7401721B2 (en) | 2005-08-15 | 2006-05-18 | Surgical stapling instruments including a cartridge having multiple staple sizes |
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CA2864538C (en) | 2017-03-28 |
US20070034667A1 (en) | 2007-02-15 |
JP5744113B2 (ja) | 2015-07-01 |
JP2019162436A (ja) | 2019-09-26 |
JP2022033944A (ja) | 2022-03-02 |
CN101073509A (zh) | 2007-11-21 |
JP2016073824A (ja) | 2016-05-12 |
JP2015013157A (ja) | 2015-01-22 |
CA2864538A1 (en) | 2007-11-18 |
CN101073509B (zh) | 2010-12-22 |
EP1857057A2 (en) | 2007-11-21 |
JP6734428B2 (ja) | 2020-08-05 |
JP2020138033A (ja) | 2020-09-03 |
CA2588825C (en) | 2014-12-09 |
JP2018020149A (ja) | 2018-02-08 |
US20100270356A1 (en) | 2010-10-28 |
EP1857057B1 (en) | 2016-12-14 |
AU2007202085B2 (en) | 2012-08-09 |
CA2937565A1 (en) | 2007-11-18 |
JP5939652B2 (ja) | 2016-06-22 |
JP2007307373A (ja) | 2007-11-29 |
AU2007202085A1 (en) | 2007-12-06 |
EP1857057A3 (en) | 2011-03-09 |
US20080272175A1 (en) | 2008-11-06 |
JP2013223765A (ja) | 2013-10-31 |
US7401721B2 (en) | 2008-07-22 |
CA2588825A1 (en) | 2007-11-18 |
CA2937565C (en) | 2018-08-28 |
ES2617088T3 (es) | 2017-06-15 |
US7828189B2 (en) | 2010-11-09 |
US8113407B2 (en) | 2012-02-14 |
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