JP5420557B2 - 有効長さを増加させた折り畳み超音波エンドエフェクタ - Google Patents
有効長さを増加させた折り畳み超音波エンドエフェクタ Download PDFInfo
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
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- B06B3/00—Methods or apparatus specially adapted for transmitting mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B2017/22014—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
- A61B2017/22015—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B2017/22014—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
- A61B2017/22015—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
- A61B2017/22018—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member segmented along its length
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
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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
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
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Description
中空コア及び中実コア要素の両方を含む超音波器具は、多くの病状に対する安全で有効な治療のために使用される。超音波器具及び特に接触超音波要素を備える超音波器具は有利であるが、それはこれらが超音波周波数で外科用エンドエフェクタに伝送される機械的振動の形態でエネルギーを使用して組織を切断する及び/又は凝固させるのに使用され得るからである。接触超音波要素を利用する超音波器具は特に有利であるが、それは、超音波変換器から伝送構成要素又は導波路を介して外科用エンドエフェクタに伝送され得る超音波エネルギーの量のためである。このような器具は、内視鏡若しくは腹腔鏡外科手術などの、開放又は低侵襲外科手術に使用することができ、エンドエフェクタはトロカールを通って手術部位に到達する。
d=A(x)sin(ωt) (1)
式中、
ω=周期的振動数fの2π倍に等しい角振動数、
A(x)=ブレードに沿った位置xの関数としてのゼロからピークまでの振幅である。
一実施形態では、超音波手術器具と共に使用するためのエンドエフェクタは、長手方向軸線に沿って延びる本体を備える。本体は、近位端及び遠位端を含む。本体の近位端は、所定の周波数で振動を生み出すように構成される超音波変換器に連結するように構成される。折り畳み要素は、ノードと波腹との間の所定の領域で、本体の遠位端に連結される第1の末端部を備える。折り畳み要素は、本体の遠位端から近位端へ長手方向軸線に沿って延びる。折り畳み要素は、第2の自由音響端を備える。本体の遠位部及び折り畳み要素は、平行音響経路を画定する。
様々な実施形態について詳細に説明する前に、実施形態は、その適用又は用途において、添付図面及び説明の文脈において例示される部品の構造及び配列の詳細に限定されないことに留意すべきである。例示的な諸実施形態は、他の実施形態、変形形態、及び修正形態に実装されるか、又は組み込まれてもよく、様々な方法で実践又は実施されてよい。例えば、以下に開示される外科用器具及びエンドエフェクタの構成は、単に例示的なものであり、それらの範囲又は用途を限定することを意図しない。更に、特に指示がない限り、本明細書で用いる用語及び表現は、読者の便宜のために例示的な諸実施形態を説明する目的で選択されたものであって、この文脈に限定されない。
熱=μvN (2)
式中、
μ=摩擦係数、
v=超音波速度の二乗平均平方根(rms)値、及び、
N=垂直力。
(1) 超音波手術器具と共に使用するためのエンドエフェクタにおいて、
近位端と遠位端とを備える長手方向軸線に沿って延びる本体であって、該本体の該近位端は、所定の周波数で振動を生み出すように構成される超音波変換器に連結するように構成される、本体と、
ノードと波腹との間の所定の領域で、該本体の該遠位端に連結される第1の末端部を備える折り畳み要素であって、該折り畳み要素は、該本体の該遠位端から該近位端へ該長手方向軸線に沿って延び、該折り畳み要素は、第2の自由音響端を備え、該本体の遠位部及び該折り畳み要素は、平行音響経路を画定する、折り畳み要素と、を備える、エンドエフェクタ。
(2) 前記本体は、管状部材として構成され、前記折り畳み要素は、中実部材として構成される、実施態様1に記載のエンドエフェクタ。
(3) 前記本体は、前記折り畳み要素を受容するためのスロットを備える、実施態様1に記載のエンドエフェクタ。
(4) 前記折り畳み要素に動作可能に連結されるクランプアームを備える、実施態様1に記載のエンドエフェクタ。
(5) 前記クランプアームに連結される組織パッドを備える、実施態様4に記載のエンドエフェクタ。
(6) 前記クランプアームは、前記本体に対して所定の力プロファイルを印加するように構成され、該力は、該本体の有効長さの変位プロファイルに反比例する、実施態様4に記載のエンドエフェクタ。
(7) 前記クランプアームは、板バネとして構成される、実施態様6に記載のエンドエフェクタ。
(8) 前記クランプアームは、第1及び第2のヒンジ式クランプアーム部材に、動作可能に連結されるバネを備える、実施態様6に記載のエンドエフェクタ。
(9) 前記折り畳み要素は、前記長手方向軸線に沿って延長可能である、実施態様1に記載のエンドエフェクタ。
(10) 前記延長可能な折り畳み要素は、前記長手方向軸線に沿ってスライド自在に移動可能である、実施態様9に記載のエンドエフェクタ。
(12) 挿入折り畳み要素が、フックとして形成される、実施態様1に記載のエンドエフェクタ。
(13) 前記本体の前記遠位端は、ノードに近接して位置し、
前記折り畳み要素の前記音響遠位端は、波腹に近接して位置する、実施態様1に記載のエンドエフェクタ。
(14) 前記本体の前記遠位端は、ノードと波腹との間に位置する第1の変位領域と実質的に一致し、
前記折り畳み要素の前記音響遠位端は、ノードと波腹との間に位置する第2の変位領域と実質的に一致する、実施態様1に記載のエンドエフェクタ。
(15) 外科用器具において、
所定の周波数で長手方向軸線に沿って振動を生み出すように構成された変換器と、
該変換器に連結される該長手方向軸線に沿って延びる超音波エンドエフェクタであって、
近位端と遠位端とを備える長手方向軸線に沿って延びる本体であって、該本体の該近位端は、所定の周波数で振動を生み出すように構成される超音波変換器に連結されるように構成される、本体と、
ノードと波腹との間の所定の領域で、該本体の該遠位端に連結される第1の末端部を備える折り畳み要素であって、該折り畳み要素は、該本体の該遠位端から該近位端に、該長手方向軸線に沿って延び、該折り畳み要素は、第2の自由音響端を備え、該本体の遠位部及び該折り畳み要素は、平行音響経路を画定する、折り畳み要素と、
を備える、超音波エンドエフェクタと、を備える、外科用器具。
(16) 前記折り畳み要素に動作可能に連結されるクランプアームを備える、実施態様15に記載の外科用器具。
(17) 超音波手術器具と共に使用するためのエンドエフェクタにおいて、
近位端と遠位端とを備える長手方向軸線に沿って延びる本体であって、該本体の該近位端は、所定の周波数で振動を生み出すように構成される超音波変換器に連結されるように構成される、本体と、
ノードと波腹との間の所定の領域で、該本体の該遠位端に連結される第1の末端部を備える折り畳み要素であって、該折り畳み要素は、該本体の該遠位端から該近位端へ該長手方向軸線に沿って延び、該折り畳み要素は、第2の自由音響端を備え、該本体の遠位部及び該折り畳み要素は、平行音響経路を画定し、該折り畳み要素は、該本体の側部に形成される密封縁部を備える、折り畳み要素と、
該折り畳み要素に動作可能に連結されるクランプアームと、を備える、エンドエフェクタ。
(18) 前記クランプアームに連結される組織パッドを備える、実施態様17に記載のエンドエフェクタ。
(19) 前記クランプアームは、前記組織パッドと前記密封縁部との間に所定の力を印加するように構成される、実施態様18に記載のエンドエフェクタ。
(20) 前記本体は、前記第1の密封縁部と前記第2の密封縁部との間にナイフを受容するように適合される、実施態様17に記載のエンドエフェクタ。
Claims (14)
- 超音波手術器具と共に使用するためのエンドエフェクタにおいて、
近位端と遠位端とを備える長手方向軸線に沿って延びる本体であって、該本体の該近位端は、所定の周波数で振動を生み出すように構成される超音波変換器に連結するように構成される、本体と、
ノードと波腹との間の所定の領域で、該本体の該遠位端に連結される第1の末端部を備える折り畳み要素であって、該折り畳み要素は、該本体の該遠位端から該近位端へ該長手方向軸線に沿って延び、該折り畳み要素は、第2の自由音響端を備え、該本体の遠位部及び該折り畳み要素は、平行音響経路を画定する、折り畳み要素と、を備える、エンドエフェクタ。 - 前記本体は、管状部材として構成され、前記折り畳み要素は、中実部材として構成される、請求項1に記載のエンドエフェクタ。
- 前記本体は、前記折り畳み要素を受容するためのスロットを備える、請求項1に記載のエンドエフェクタ。
- 前記折り畳み要素に動作可能に連結されるクランプアームを備える、請求項1に記載のエンドエフェクタ。
- 前記クランプアームに連結される組織パッドを備える、請求項4に記載のエンドエフェクタ。
- 前記クランプアームは、前記本体に対して所定の力プロファイルを印加するように構成され、該力は、該本体の有効長さの変位プロファイルに反比例する、請求項4に記載のエンドエフェクタ。
- 前記クランプアームは、板バネとして構成される、請求項6に記載のエンドエフェクタ。
- 前記クランプアームは、第1及び第2のヒンジ式クランプアーム部材に、動作可能に連結されるバネを備える、請求項6に記載のエンドエフェクタ。
- 前記折り畳み要素は、前記長手方向軸線に沿って延長可能である、請求項1に記載のエンドエフェクタ。
- 前記延長可能な折り畳み要素は、前記長手方向軸線に沿ってスライド自在に移動可能である、請求項9に記載のエンドエフェクタ。
- 前記延長可能な折り畳み要素は、前記本体の前記遠位端に位置する旋回軸線の周りを回転可能に移動可能である、請求項9に記載のエンドエフェクタ。
- 挿入折り畳み要素が、フックとして形成される、請求項1に記載のエンドエフェクタ。
- 前記本体の前記遠位端は、ノードに近接して位置し、
前記折り畳み要素の前記第2の自由音響端は、波腹に近接して位置する、請求項1に記載のエンドエフェクタ。 - 前記本体の前記遠位端は、ノードと波腹との間に位置する第1の変位領域と実質的に一致し、
前記折り畳み要素の前記第2の自由音響端は、ノードと波腹との間に位置する第2の変位領域と実質的に一致する、請求項1に記載のエンドエフェクタ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/998,758 US7901423B2 (en) | 2007-11-30 | 2007-11-30 | Folded ultrasonic end effectors with increased active length |
US11/998,758 | 2007-11-30 | ||
PCT/US2008/083735 WO2009070462A1 (en) | 2007-11-30 | 2008-11-17 | Folded ultrasonic end effectors with increased active length |
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JP2011505194A JP2011505194A (ja) | 2011-02-24 |
JP5420557B2 true JP5420557B2 (ja) | 2014-02-19 |
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JP2010536059A Expired - Fee Related JP5420557B2 (ja) | 2007-11-30 | 2008-11-17 | 有効長さを増加させた折り畳み超音波エンドエフェクタ |
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US (3) | US7901423B2 (ja) |
EP (1) | EP2224863B1 (ja) |
JP (1) | JP5420557B2 (ja) |
CN (1) | CN101883529B (ja) |
AU (1) | AU2008329978C1 (ja) |
CA (1) | CA2707195A1 (ja) |
WO (1) | WO2009070462A1 (ja) |
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US8182501B2 (en) | 2004-02-27 | 2012-05-22 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical shears and method for sealing a blood vessel using same |
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CA2707195A1 (en) | 2009-06-04 |
US20090143796A1 (en) | 2009-06-04 |
US20110125175A1 (en) | 2011-05-26 |
AU2008329978A1 (en) | 2009-06-04 |
AU2008329978C1 (en) | 2013-11-21 |
US8372102B2 (en) | 2013-02-12 |
EP2224863B1 (en) | 2017-08-02 |
CN101883529B (zh) | 2012-11-14 |
CN101883529A (zh) | 2010-11-10 |
WO2009070462A1 (en) | 2009-06-04 |
EP2224863A1 (en) | 2010-09-08 |
US20120203257A1 (en) | 2012-08-09 |
JP2011505194A (ja) | 2011-02-24 |
US7901423B2 (en) | 2011-03-08 |
AU2008329978B2 (en) | 2013-04-11 |
US8182502B2 (en) | 2012-05-22 |
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