JP5421927B2 - 内視鏡を使用して穴を縫合するための医療装置、器具及び方法 - Google Patents
内視鏡を使用して穴を縫合するための医療装置、器具及び方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
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- A—HUMAN NECESSITIES
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- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/062—Needle manipulators
- A61B17/0625—Needle manipulators the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator
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- A—HUMAN NECESSITIES
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Description
12 組織、
14 穴、
20 医療装置、
22 内視鏡、
23 作動通路、ガイド通路
24 医療器具、
26 エンドキャップ、
28 針、
30 遠位の把持装置、上方把持装置、把持装置、第一の把持装置
32 近位の把持装置、下方の把持装置、把持装置、第二の把持装置
34 縫合領域、縫合空間、
36 縫合糸、
38 管状本体、
40 内部空洞、
42 第一のガイド本体、
44 第二のガイド本体、
48 遠位のガイドフランジ、
50 近位のガイドフランジ、
52 補強リブ、
54 通路、
56 通路、
58 支持アーム、
60 ガイドフランジ、
62 ガイド穴、
70 把持アーム、
72 把持プレート、
72R 把持プレート72の右半分、
72L 把持プレート72の左半分、
74 制御ワイヤー、
76 結合プレート、
78 シース、
80 ガイドロッド、
82 把持ブラケット、
84 すり割り、
86 把持ブラケット82の自由端、
88 ガイド穴、
90 一対の取付け穴、
92 取り付け穴、
94 把持穴、
96 スリット、
100 針の細長い本体、細長い本体、針本体、針、ニードル28の本体
102 本体100の第一の端部、
104 本体100の反対側の端部、
106 環状の切り込み、第一の切り込み、切り込み
108 第二の切り込み、第二の環状の切り込み、溝
110 コレット、
112 制御ワイヤー、
114 カテーテル、
116 基部、
118 把持用指状部、
120 内部空間、
122 把持用指状部118の遠位端、
124 歯、
200 針本体、
202 針本体の第一の端部、
204 針本体の第二の端部、
206 第一の環状リブ、第一のリブ
208 第二の環状リブ、
370 把持アーム、
372R、372L、 把持ワイヤー、ワイヤー
372 すり割り、
432 下方の把持装置、近位の把持装置、
418 把持用指状部、第二の把持用指状部
420 内部空間、
422 制御ワイヤー、
424 枢軸、
520 医療装置、
522 内視鏡、
524 医療器具、
526 エンドキャップ、
530 遠位の把持装置、
532 近位の把持装置、
542 第一の支持本体、
544 第二の支持本体、第二の支持構造、
562 ガイド穴、
570 L字形状のアーム、
582 把持ブラケット、
584 把持プレート、
630 遠位の把持装置、
670 把持アーム、
682 把持ブラケット、
684 すり割り、
688 ガイド穴、
730 遠位の把持装置、
770 把持アーム、
782 把持ブラケット、
784 第一の結合部、
786 第二の湾曲した部分、
788 第三の端部
Claims (18)
- 組織の穴を縫合するための医療装置であり、
作動通路(23)を有し且つ長手軸線を規定している内視鏡(22)と、
前記内視鏡の遠位端に嵌合されているエンドキャップ(26,526,726)と、
第一の端部と該第一の端部と反対側の第二の端部とを有している針(28,128)と、
前記針に取り付けられた縫合糸(36)と、
長手方向に並進するために前記エンドキャップに長手方向に摺動可能に結合されており且つ前記針と選択的に係合する構造とされている第一の把持装置(30,330,530,630,730)と、
前記針と選択的に係合する構造とされ且つ長手方向に並進するように前記内視鏡の前記作動通路を摺動可能に貫通している第二の把持装置であり、前記内視鏡の作動通路内を貫通して延びている制御部材(112)、及び前記作動通路と長手方向で整列されて、前記針と選択的に係合する構造とされている調整可能な穴(120,420)を備え、前記穴に係合された針に対して調整可能な把持力を有している、第二の把持装置(32,432,532)と、を備えており、
前記第一の把持装置と第二の把持装置とは、前記針を、前記第一の把持装置と第二の把持装置との間を選択的に通すために相対的に長手方向に並進する構造とされている、医療装置。 - 前記第二の把持装置がコレット(110)であり、該コレットは、前記針の外周を包囲する大きさ及び配置とされている可撓性の指状部(122)を備えている、請求項1に記載の医療装置。
- 前記第一の把持装置が、調整不可能な把持力を有している、請求項1に記載の医療装置。
- 前記第一の把持装置が、本来の状態が前記針と係合する大きさである調整可能な開口部(94,688,798)を備えている、請求項3に記載の医療装置。
- 前記調整可能な穴が把持部材(72,372,584,682,782)によって規定されており、前記把持部材は、該把持部材内を長手方向に延びており且つ該把持部材の一つの横面において開口しているすり割り(96,684,794)と、該すり割りと同一の伸長長さを有し且つ前記針を受け入れる大きさ及び配置とされている把持穴(94,688,798)とを備えている、請求項4に記載の医療装置。
- 前記コレットが、本来の状態が前記針と係合する大きさである調整可能な開口部(120)を備えている、請求項2に記載の医療装置。
- 前記第二の把持装置が、前記調整可能な開口部の大きさを小さくするように手動によって調整できる、請求項6に記載の医療装置。
- 前記第一の把持装置がL字形状の把持アーム(70,570,670,770)を有しており、該L字形状の把持アームが、前記作動通路及び前記第二の把持装置の前記調整可能な開口部と径方向に整列された把持穴(94,688,798)を有している、請求項1に記載の医療装置。
- 前記第一の把持装置(30,330,530,630,730)が、所定の第一の把持力によって前記針に選択的に係合する構造とされ、
前記第二の把持装置(32,432,532)が、前記第一の把持装置から長手方向に隔てられており且つ第二の把持力によって前記針と選択的に係合する構造とされており、
前記第二の把持装置は、前記第二の把持力を、第一の強さと第二の強さとの間で変更する調整可能な把持力を有している、請求項1に記載の医療器具。 - 前記第二の把持力の前記第一の強さが前記第一の把持力よりも弱く、前記第二の把持力の前記第二の強さが前記第一の把持力よりも強い、請求項9に記載の医療器具。
- 前記第一の把持装置が、弾性材料によって形成されている把持部材(72,372,584,682,782)であり、該把持部材は、該把持部材内を長手方向に延びており且つ該把持部材の一つの横面において開口しているすり割り(96,684,794)を有しており、更に、前記すり割りと同一の伸長長さを有し且つ前記針を受け入れる大きさ及び配置とされている把持穴(94,688,798)を備えており、前記把持部材を形成している弾性材料は、撓んで前記把持穴の大きさを調整することができる、請求項9に記載の医療器具。
- 前記第一の把持装置が、間に調整可能な空間を規定している一対のワイヤー(372R,372L)である、請求項9に記載の医療器具。
- 前記第二の把持装置が、可撓性の指状部(122)を備えているコレット(110)である、請求項9に記載の医療器具。
- 前記第二の把持装置がカテーテル(114)を備えており、前記カテーテルと前記コレットとの間の相対的な並進によって、前記第二の把持力が、前記第一の強さと第二の強さとの間で調整されるようになされた、請求項13に記載の医療器具。
- 前記第二の把持装置が鉗子(432)からなる、請求項9に記載の医療器具。
- 前記第一の把持装置が、前記エンドキャップの外側部分に摺動可能に取り付けられているL字形状の把持アーム(70,570,670,770)を備えており、前記第一の把持装置は、前記内視鏡の外側に沿って延びている制御部材(74)を備えている、請求項9に記載の医療装置。
- 前記第一の把持装置がL字形状の把持アーム(770)を備えており、該L字形状の把持アームは、前記内視鏡によって該把持アームの前方を見るのを容易にするために前記エンドキャップの直径に対応する湾曲形状を有している、請求項10に記載の医療装置。
- 前記エンドキャップが前記第二の把持装置のための支持アームを備えており、該支持アーム(58,544)は、前記第二の把持装置の把持部材と整列されているガイド穴(62,562)を備えている、請求項9に記載の医療器具。
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Application Number | Priority Date | Filing Date | Title |
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US1878608P | 2008-01-03 | 2008-01-03 | |
US61/018,786 | 2008-01-03 | ||
PCT/US2009/030030 WO2009089101A2 (en) | 2008-01-03 | 2009-01-02 | Medical systems, devices and methods for endoscopically suturing perforations |
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JP2011509121A JP2011509121A (ja) | 2011-03-24 |
JP5421927B2 true JP5421927B2 (ja) | 2014-02-19 |
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US (1) | US8876701B2 (ja) |
EP (1) | EP2230987B1 (ja) |
JP (1) | JP5421927B2 (ja) |
AU (1) | AU2009204417B2 (ja) |
CA (1) | CA2711300A1 (ja) |
WO (1) | WO2009089101A2 (ja) |
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WO2019230906A1 (ja) * | 2018-05-31 | 2019-12-05 | 国立大学法人九州大学 | 自動運針器 |
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US8075572B2 (en) | 2007-04-26 | 2011-12-13 | Ethicon Endo-Surgery, Inc. | Surgical suturing apparatus |
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US20090112059A1 (en) | 2007-10-31 | 2009-04-30 | Nobis Rudolph H | Apparatus and methods for closing a gastrotomy |
US8262680B2 (en) | 2008-03-10 | 2012-09-11 | Ethicon Endo-Surgery, Inc. | Anastomotic device |
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-
2009
- 2009-01-02 WO PCT/US2009/030030 patent/WO2009089101A2/en active Application Filing
- 2009-01-02 CA CA2711300A patent/CA2711300A1/en not_active Abandoned
- 2009-01-02 EP EP09700321A patent/EP2230987B1/en active Active
- 2009-01-02 US US12/348,180 patent/US8876701B2/en active Active
- 2009-01-02 AU AU2009204417A patent/AU2009204417B2/en active Active
- 2009-01-02 JP JP2010541574A patent/JP5421927B2/ja active Active
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2019230906A1 (ja) * | 2018-05-31 | 2019-12-05 | 国立大学法人九州大学 | 自動運針器 |
US11627956B2 (en) | 2018-05-31 | 2023-04-18 | Kyushu University, National University Corporation | Automatic needle mover |
Also Published As
Publication number | Publication date |
---|---|
WO2009089101A2 (en) | 2009-07-16 |
AU2009204417B2 (en) | 2013-05-09 |
CA2711300A1 (en) | 2009-07-16 |
AU2009204417A1 (en) | 2009-07-16 |
US20090177031A1 (en) | 2009-07-09 |
WO2009089101A3 (en) | 2009-10-22 |
US8876701B2 (en) | 2014-11-04 |
EP2230987A2 (en) | 2010-09-29 |
JP2011509121A (ja) | 2011-03-24 |
EP2230987B1 (en) | 2013-02-27 |
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