JP5513276B2 - ダブルカートリッジとアンビルアセンブリとを有する外科手術器具 - Google Patents
ダブルカートリッジとアンビルアセンブリとを有する外科手術器具 Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
- A61B17/1155—Circular staplers comprising a plurality of staples
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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
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
- A61B17/105—Wound clamp magazines
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
-
- 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
- A61B2017/07257—Stapler heads characterised by its anvil
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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
- 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
- A61B2017/07278—Stapler heads characterised by its sled or its staple holder
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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
- A61B2017/07285—Stapler heads characterised by its cutter
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
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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
- A61B2017/320052—Guides for cutting instruments
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Description
本出願は、2009年7月11日に出願された仮出願第61/224,854号からの優先権を主張し、該仮出願の内容全体が本明細書に参考として援用される。
本開示は、概して外科手術器具および外科手術を実行する方法に関する。より具体的には、本開示は、組織をクランプし、切断し、そして/または接合するための外科手術器具および方法に関する。
特定の外科手術ステープリング器具は、圧縮された生組織を介して複数の列のステープルを適用するために用いられる。これらの外科手術ステープリング器具は、例えば、離断または切除の前あるいは吻合中に、組織または器官を締結するために用いられる。一部の場合において、これらの外科手術ステープリング器具は、胸部および腹部の処置において器官を閉塞するために利用される。
本開示は、一局面において、外科手術器具と共に使用するエンドエフェクタに関する。エンドエフェクタは、第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、第1のカートリッジアセンブリの遠位に配置される第2のカートリッジアセンブリとを含む。第2のカートリッジアセンブリは、開放位置と接近位置との間を動くように構成される。中心ロッドは、第1のカートリッジアセンブリと第2のカートリッジアセンブリとの間に延びる。
第1のカートリッジアセンブリと、第1のカートリッジアセンブリの遠位に配置される第1のアンビルアセンブリと、第1のアンビルアセンブリの遠位に配置される第2のアンビルアセンブリと、第2のアンビルアセンブリの遠位に配置される第2のカートリッジアセンブリとを含む。第2のカートリッジアセンブリは、第2のアンビルアセンブリに対して開放位置と接近位置との間を動くように構成される。中心ロッドは、第1のカートリッジアセンブリと第2のカートリッジアセンブリとの間に延びる。
(項目1)
外科手術器具と共に使用するエンドエフェクタであって、
第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、
該第1のカートリッジアセンブリの遠位に配置される第2のカートリッジアセンブリであって、該第2のカートリッジアセンブリは、開放位置と接近位置との間を動き、組織をクランプするように構成される、第2のカートリッジアセンブリと、
該第1のカートリッジアセンブリと該第2のカートリッジアセンブリとの間に延びる中心ロッドと
を備えている、エンドエフェクタ。
(項目2)
上記第1のカートリッジアセンブリの遠位に配置される第1のアンビルアセンブリをさらに備えている、上記項目のいずれかに記載のエンドエフェクタ。
(項目3)
上記第1のアンビルアセンブリの遠位に配置される第2のアンビルアセンブリをさらに備え、上記第2のカートリッジは、該第2のアンビルアセンブリに対して動くように構成される、上記項目のいずれかに記載のエンドエフェクタ。
(項目4)
上記第2のカートリッジアセンブリは、該第2のカートリッジアセンブリが上記接近位置に動くと、第2の組のファスナを配備するように構成される、上記項目のいずれかに記載のエンドエフェクタ。
(項目5)
上記第1のアンビルアセンブリおよび上記第2のアンビルアセンブリの各々は、上記中心ロッドの動きに応答する動きのために、該中心ロッドに取り付けられる、上記項目のいずれかに記載のエンドエフェクタ。
(項目6)
上記第2のカートリッジアセンブリは、第2の組のファスナと、遠位位置と近位位置との間を動き、該第2のカートリッジアセンブリから該第2の組のファスナを排出するように適合されたファスナプッシャとを含む、上記項目のいずれかに記載のエンドエフェクタ。
(項目7)
上記第2のカートリッジアセンブリの上記ファスナプッシャは、上記中心ロッドに動作可能に接続される、上記項目のいずれかに記載のエンドエフェクタ。
(項目8)
上記第2のカートリッジアセンブリは付勢部材をさらに備え、該付勢部材は上記ファスナプッシャに対抗してカートリッジハウジングを付勢する、上記項目のいずれかに記載のエンドエフェクタ。
(項目9)
上記第1のカートリッジアセンブリは、近位位置と遠位位置との間で可動であるナイフをさらに備えている、上記項目のいずれかに記載のエンドエフェクタ。
(項目10)
上記第1のアンビルアセンブリは、弱化した部分であって、上記ナイフが該部分を通って動くとき破断するように構成される、弱化した部分を含む、上記項目のいずれかに記載のエンドエフェクタ。
(項目11)
上記エンドエフェクタは、外科手術器具に取り外し可能に取り付け可能である、上記項目のいずれかに記載のエンドエフェクタ。
(項目12)
上記第1のアンビルアセンブリは、実質的に環状のアレイに配列され、上記第1の組のファスナを変形するように構成される複数のアンビルポケットを備え、該第1の組のファスナは、実質的に環状のアレイに配列される、上記項目のいずれかに記載のエンドエフェクタ。
(項目13)
上記中心ロッドは、上記外科手術器具のロッドに取り外し可能に取り付けられ、該中心ロッドは、上記アンビルアセンブリおよびファスナカートリッジアセンブリに接近するようにスライド可能である、上記項目のいずれかに記載のエンドエフェクタ。
(項目14)
組織を接合する外科手術器具と組み合わせるエンドエフェクタであって、該外科手術器具は、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位に延びる細長い部分であって、該細長い部分は、近位部分と遠位部分とを有し、該エンドエフェクタは該遠位部分に隣接して配置される、細長い部分と
を備えている、上記項目のいずれかに記載のエンドエフェクタ。
(項目15)
上記第2の組のファスナは、実質的に環状のアレイで配列される、上記項目のいずれかに記載の外科手術器具。
(項目1A)
外科手術器具と共に使用するエンドエフェクタであって、
第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、
該第1のカートリッジアセンブリの遠位に配置される第2のカートリッジアセンブリであって、該第2のカートリッジアセンブリは、開放位置と接近位置との間を動き、組織をクランプするように構成される、第2のカートリッジアセンブリと、
該第1のカートリッジアセンブリと該第2のカートリッジアセンブリとの間に延びる中心ロッドと
を備えている、エンドエフェクタ。
(項目2A)
上記第1のカートリッジアセンブリの遠位に配置される第1のアンビルアセンブリをさらに備えている、上記項目のいずれかに記載のエンドエフェクタ。
(項目3A)
上記第1のアンビルアセンブリの遠位に配置される第2のアンビルアセンブリをさらに備え、上記第2のカートリッジは、該第2のアンビルアセンブリに対して動くように構成される、上記項目のいずれかに記載のエンドエフェクタ。
(項目4A)
上記第2のカートリッジアセンブリは、該第2のカートリッジアセンブリが上記接近位置に動くと、第2の組のファスナを配備するように構成される、上記項目のいずれかに記載のエンドエフェクタ。
(項目5A)
上記第1のアンビルアセンブリおよび上記第2のアンビルアセンブリの各々は、上記中心ロッドの動きに応答する動きのために、該中心ロッドに取り付けられる、上記項目のいずれかに記載のエンドエフェクタ。
(項目6A)
上記第2のカートリッジアセンブリは、第2の組のファスナと、遠位位置と近位位置との間を動き、該第2のカートリッジアセンブリから該第2の組のファスナを排出するように適合されたファスナプッシャとを含む、上記項目のいずれかに記載のエンドエフェクタ。
(項目7A)
上記第2のカートリッジアセンブリの上記ファスナプッシャは、上記中心ロッドに動作可能に接続される、上記項目のいずれかに記載のエンドエフェクタ。
(項目8A)
上記第2のカートリッジアセンブリは付勢部材をさらに備え、該付勢部材は上記ファスナプッシャに対抗してカートリッジハウジングを付勢する、上記項目のいずれかに記載のエンドエフェクタ。
(項目9A)
上記第1のカートリッジアセンブリは、近位位置と遠位位置との間で可動であるナイフをさらに備えている、上記項目のいずれかに記載のエンドエフェクタ。
(項目10A)
上記第1のアンビルアセンブリは、弱化した部分であって、上記ナイフが該部分を通って動くとき破断するように構成される、弱化した部分を含む、上記項目のいずれかに記載のエンドエフェクタ。
(項目11A)
上記エンドエフェクタは、外科手術器具に取り外し可能に取り付け可能である、上記項目のいずれかに記載のエンドエフェクタ。
(項目12A)
上記第1のアンビルアセンブリは、実質的に環状のアレイに配列され、上記第1の組のファスナを変形するように構成される複数のアンビルポケットを備え、該第1の組のファスナは、実質的に環状のアレイに配列される、上記項目のいずれかに記載のエンドエフェクタ。
(項目13A)
上記中心ロッドは、上記外科手術器具のロッドに取り外し可能に取り付けられ、該中心ロッドは、上記アンビルアセンブリおよびファスナカートリッジアセンブリに接近するようにスライド可能である、上記項目のいずれかに記載のエンドエフェクタ。
組織を接合する外科手術器具であって、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位に延びる細長い部分であって、該細長い部分は、近位部分と遠位部分とを有する、細長い部分と、
該細長い部分の該遠位部分に隣接して配置されるエンドエフェクタであって、該エンドエフェクタは、
第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、
該第1のカートリッジアセンブリの遠位に配置される第1のアンビルアセンブリと、
該第1のアンビルアセンブリの遠位に配置される第2のアンビルアセンブリと、
該第2のアンビルアセンブリの遠位に配置される第2のカートリッジアセンブリであって、該第2のカートリッジアセンブリは、該第2のアンビルアセンブリに対して開放位置と接近位置との間を動くように構成される、第2のカートリッジアセンブリと、
該第1のカートリッジアセンブリと該第2のカートリッジアセンブリとの間に延びる中心ロッドと
を含む、エンドエフェクタと
を備えている、外科手術器具。
上記第2のカートリッジアセンブリは、該第2のカートリッジアセンブリが上記接近位置に動くと、第2の組のファスナを配備するように構成され、該第2のカートリッジアセンブリは、遠位位置と近位位置との間を動き、該第2の組のファスナを排出するように適合されたファスナプッシャを含む、上記項目のいずれかに記載の外科手術器具。
上記第1のアンビルアセンブリおよび上記第2のアンビルアセンブリの各々は、上記中心ロッドの動きに応答して動くように該中心ロッドに取り付けられる、上記項目のいずれかに記載の外科手術器具。
上記第1のカートリッジアセンブリは、近位位置と遠位位置との間で可動であるナイフをさらに備え、上記第1のアンビルアセンブリは、弱化した部分であって、上記ナイフが該部分を通って動くとき破断するように構成される、弱化した部分を含む、上記項目のいずれかに記載の外科手術器具。
上記第1組のファスナおよび第2の組のファスナは、実質的に環状のアレイで配列される、上記項目のいずれかに記載の外科手術器具。
外科手術を実行する方法であって、
管状の器官の内部にエンドエフェクタを挿入するステップであって、該エンドエフェクタは、第1の組のファスナを収納する第1のカートリッジアセンブリと、該第1のカートリッジアセンブリの遠位に配置される第1のアンビルアセンブリと、該第1のアンビルアセンブリの遠位に配置される第2のアンビルアセンブリと、該第2のアンビルアセンブリの遠位に配置される第2のカートリッジアセンブリであって、該第2のカートリッジアセンブリは、該第2のアンビルアセンブリに対して開放位置と接近位置との間を動くように構成される、第2のカートリッジアセンブリと、該第1のカートリッジアセンブリと該第2のカートリッジアセンブリとの間に延びる中心ロッドとを含む、ステップと、
該管状の器官の第1の組織部分を該中心ロッドの方に引き、該第2のカートリッジアセンブリと該第2のアンビルアセンブリとの間に位置を定められる第1の領域の中に引き込むステップと、
該管状の器官の第2の組織部分を該中心ロッドの方に引き、該第1のアンビルアセンブリと該第2のアンビルアセンブリとの間に位置を定められる第2の領域の中に引き込むステップと、
該管状の器官の第3の組織部分を該中心ロッドの方に引き、該第1のアンビルアセンブリと該第1のカートリッジアセンブリとの間に位置を定められる第3の領域の中に引き込むステップと、
該エンドエフェクタを発射して、該第1の組織部分の複数の部分を締結し、該第3の複数の部分を締結するステップと
を包含する、方法。
上記エンドエフェクタは、上記第1のカートリッジアセンブリと動作可能に関連付けられるナイフを含み、該ナイフを用いて上記第2の組織部分を切断するステップをさらに包含する、上記項目のいずれかに記載の方法。
外科手術器具と共に使用するエンドエフェクタであって、第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、第1のカートリッジアセンブリの遠位に配置される第2のカートリッジアセンブリとを有する、エンドエフェクタ。第2のカートリッジアセンブリは、クランプする組織に対して開放位置と接近位置との間を動くように構成される。中心ロッドは第1のカートリッジアセンブリと第2のカートリッジアセンブリとの間に延びる。
本明細書で開示される外科手術器具の実施形態が、図面を参照して詳細に説明され、図面において同様の参照数字は、いくつかの図の各々において対応する要素を示す。以下の説明において、用語「近位」は、ユーザにより近い、外科手術器具の端部または部分をいい、一方、用語「遠位」は、ユーザからより遠くに離れている、外科手術器具の端部または部分をいう。
12 ハンドルアセンブリ
14 中心本体部分
16 エンドエフェクタ
18 固定ハンドル
20 発射トリガ
22 接近ノブ
24 インジケータ
26 トリガロック
28 第1のカートリッジアセンブリ
30 遠位端
32 第2のカートリッジアセンブリ
34 第1のアンビルアセンブリ
36 第2のアンビルアセンブリ
38 中心ロッド
Claims (15)
- 外科手術器具と共に使用するエンドエフェクタであって、
第1の組のファスナを配備するように構成される第1のカートリッジアセンブリと、
該第1のカートリッジアセンブリに関連付けられた第1のアンビルアセンブリと、
該第1のカートリッジアセンブリの遠位に配置される第2のカートリッジアセンブリと、
該第2のカートリッジアセンブリに関連付けられた第2のアンビルアセンブリであって、該第2のカートリッジアセンブリは、該第2のアンビルアセンブリに対して、開放位置と接近位置との間を動き、組織をクランプするように構成される、第2のアンビルアセンブリと、
該第1のカートリッジアセンブリと該第2のカートリッジアセンブリとの間に延びる中心ロッドと
を備えている、エンドエフェクタ。 - 前記第1のアンビルアセンブリは、前記第1のカートリッジアセンブリの遠位に配置される、請求項1に記載のエンドエフェクタ。
- 前記第2のアンビルアセンブリは、前記第1のアンビルアセンブリの遠位に配置される、請求項2に記載のエンドエフェクタ。
- 前記第2のカートリッジアセンブリは、該第2のカートリッジアセンブリが前記第2のアンビルアセンブリに対して前記接近位置に動くと、第2の組のファスナを配備するように構成される、請求項1〜3のいずれかに記載のエンドエフェクタ。
- 前記第1のアンビルアセンブリおよび前記第2のアンビルアセンブリの各々は、前記中心ロッドの動きに応答する動きのために、該中心ロッドに取り付けられる、請求項3に記載のエンドエフェクタ。
- 前記第2のカートリッジアセンブリは、第2の組のファスナと、ファスナプッシャとを含み、該ファスナプッシャは、遠位位置と近位位置との間を動き、該第2のカートリッジアセンブリから該第2の組のファスナを排出するように適合される、請求項1〜5のいずれかに記載のエンドエフェクタ。
- 前記第2のカートリッジアセンブリの前記ファスナプッシャは、前記中心ロッドに動作可能に接続される、請求項6に記載のエンドエフェクタ。
- 前記第2のカートリッジアセンブリは、付勢部材をさらに備え、該付勢部材は、前記ファスナプッシャに対抗してカートリッジハウジングを付勢する、請求項7に記載のエンドエフェクタ。
- 前記第1のカートリッジアセンブリは、近位位置と遠位位置との間で可動であるナイフをさらに備えている、請求項1〜8のいずれかに記載のエンドエフェクタ。
- 前記第1のアンビルアセンブリは、弱化した部分を含み、該弱化した部分は、前記ナイフが該部分を通って動くとき破断するように構成される、請求項9に記載のエンドエフェクタ。
- 前記エンドエフェクタは、外科手術器具に取り外し可能に取り付け可能である、請求項1〜10のいずれかに記載のエンドエフェクタ。
- 前記第1のアンビルアセンブリは、複数のアンビルポケットを備え、該複数のアンビルポケットは、実質的に環状のアレイに配列され、かつ、前記第1の組のファスナを変形するように構成され、該第1の組のファスナは、実質的に環状のアレイに配列される、請求項1〜11のいずれかに記載のエンドエフェクタ。
- 前記中心ロッドは、前記外科手術器具のロッドに取り外し可能に取り付けられ、該中心ロッドは、前記第1のアンビルアセンブリおよび前記第1のカートリッジアセンブリを接近させ、前記第2のアンビルアセンブリおよび前記第2のカートリッジアセンブリを接近させるようにスライド可能である、請求項1〜12のいずれかに記載のエンドエフェクタ。
- 組織を接合する外科手術器具と組み合わせるエンドエフェクタであって、該外科手術器具は、
ハンドルアセンブリと、
該ハンドルアセンブリから遠位に延びる細長い部分と
を備え、
該細長い部分は、近位部分と遠位部分とを有し、該エンドエフェクタは、該遠位部分に隣接して配置される、請求項1〜12のいずれかに記載のエンドエフェクタ。 - 前記第2の組のファスナは、実質的に環状のアレイで配列される、請求項1〜14のいずれかに記載の外科手術器具。
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- 2010-05-20 US US12/783,994 patent/US8276802B2/en not_active Expired - Fee Related
- 2010-06-01 AU AU2010202264A patent/AU2010202264B2/en not_active Ceased
- 2010-06-09 CA CA2706943A patent/CA2706943C/en not_active Expired - Fee Related
- 2010-06-21 JP JP2010141042A patent/JP5513276B2/ja not_active Expired - Fee Related
- 2010-07-09 EP EP20100251239 patent/EP2272442A1/en not_active Withdrawn
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2013
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US20140107676A1 (en) | 2014-04-17 |
AU2010202264B2 (en) | 2015-02-05 |
CA2706943A1 (en) | 2011-01-11 |
JP2011015962A (ja) | 2011-01-27 |
US20110006102A1 (en) | 2011-01-13 |
US8276802B2 (en) | 2012-10-02 |
AU2010202264A1 (en) | 2011-01-27 |
US9597076B2 (en) | 2017-03-21 |
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