JP5613527B2 - 外科用ファスニング装置 - Google Patents
外科用ファスニング装置 Download PDFInfo
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- JP5613527B2 JP5613527B2 JP2010241566A JP2010241566A JP5613527B2 JP 5613527 B2 JP5613527 B2 JP 5613527B2 JP 2010241566 A JP2010241566 A JP 2010241566A JP 2010241566 A JP2010241566 A JP 2010241566A JP 5613527 B2 JP5613527 B2 JP 5613527B2
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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
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B17/115—Staplers for performing anastomosis in a single operation
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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
- 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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
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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
- A61B17/1114—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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- 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
- A61B17/3205—Excision instruments
- A61B17/32053—Punch like cutting instruments, e.g. using a cylindrical or oval knife
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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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Description
本願は、米国仮特許出願第61/326,292号(2010年4月21日出願)および米国仮特許出願第61/255,529号(2009年10月28日出願)からの優先権を主張する。これらの出願の各々の全開示は、本明細書に参考として援用される。
本開示は、外科用ファスニング装置に関し、より具体的には、ファスナおよび保持具システムを有する外科用ファスニング装置に関する。
(項目1)
外科用ファスニング装置であって、
ファスナ受取フレームであって、該ファスナ受取フレーム内に形成された複数の間隔をあけて離れている開口を含む、ファスナ受取フレームと、
ファスナ支持部材であって、該ファスナ支持部材から延びている複数の間隔をあけて離れている外科用ファスナを含み、該外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織を該外科用ファスナと該ファスナ受取フレームとの間に固定し、該ファスナは、該ファスナ受取フレームと該ファスナ支持部材との間の組織厚に依存して、複数の位置において該開口と係合可能である、ファスナ支持部材と、
該ファスナ受取フレームのための保持構造であって、該ファスナ受取フレームは取外し可能に該保持構造に固定される、保持構造と、
該ファスナ支持フレームを前進させて該ファスナ受取フレームと係合させるためのプッシャと
を備えている、装置。
(項目2)
外科用ファスニング装置であって、
ファスナ受取フレームであって、該ファスナ受取フレーム内に形成された複数の間隔をあけて離れている開口を含む、ファスナ受取フレームと、
ファスナ支持部材であって、該ファスナ支持部材から延びている複数の間隔をあけて離れている外科用ファスナを含み、該外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織をその間に固定し、該ファスナと開口とは、ファスナの2つ以上の深さにおいて、該開口内におけるファスナのロッキング係合を可能にするように構成され、該ファスナの深さは、該開口の中へのファスナの前進の前に、事前設定されている、ファスナ支持部材と
を備えている、装置。
(項目3)
上記プッシャは、環状プッシャであり、上記ファスナ支持部材は、環状支持フレームを含み、該環状支持フレームから遠位方向に上記ファスナが延びている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目4)
組織を切断するために上記環状プッシャによって前進可能である環状刃をさらに備えている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目5)
上記ファスナは、該ファスナに沿って軸方向に間隔をあけられている一連のロッキングタブを有することにより、上記ファスナ受取フレーム内の上記開口のそれぞれと嵌合して様々な位置において可変の係合深さを提供する、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目6)
上記開口は、可変の係合深さを提供するために、様々な位置にある上記ファスナのそれぞれを係合する一連のロッキング表面を有する、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目7)
上記ファスナは、該ファスナ内に形成される長手方向に延びているスロットを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目8)
上記ロッキングタブは、上記ファスナ受取フレーム内の上記開口に向かう第一の方向への上記ファスナの移動を可能にし、該開口から離れる第二の反対の方向への該ファスナの移動を防止するような角度にされている、複数の突起を含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目9)
上記ファスナは、薬剤を受け取るための貯蔵器を含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目10)
上記開口は、第一の深さを有し、上記ファスナのそれぞれは、第一の長さを有し、該第一の長さは該第一の深さよりも小さい、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目11)
上記ファスナ受取フレームは、アンビルに固定された支持構造に取外し可能に固定され、実質的に環状のプッシャは、上記ファスナ支持部材を該ファスナ受取フレームとの係合へと前進させる、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目12)
上記外科用装置は、上記ファスナ支持部材の前進の範囲を決定するための信号を送るために、組織パラメータを決定するために遠位部分に設置されたセンサを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目13)
上記外科用装置は、上記ファスナ支持部材の前進の範囲を決定するための信号を送るために、装置パラメータを決定するために遠位部分に設置されたセンサを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目14)
上記複数のファスナは、実質的に一様な間隔をあけて離れている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目15)
上記ファスナ受取フレーム、上記ファスナ支持部材および上記複数のファスナは、生物分解性ポリマから作られる、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目16)
上記ファスナ支持部材は、弾性である、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目1A)
外科用ファスニング装置であって、
ファスナ受取フレームであって、該ファスナ受取フレーム内に形成された複数の間隔をあけて離れている開口を含む、ファスナ受取フレームと、
ファスナ支持部材であって、該ファスナ支持部材から延びている複数の間隔をあけて離れている外科用ファスナを含み、該外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織を該外科用ファスナと該ファスナ受取フレームとの間に固定し、該ファスナは、該ファスナ受取フレームと該ファスナ支持部材との間の組織厚に依存して、複数の位置において該開口と係合可能である、ファスナ支持部材と、
該ファスナ受取フレームのための保持構造であって、該ファスナ受取フレームは取外し可能に該保持構造に固定される、保持構造と、
該ファスナ支持フレームを前進させて該ファスナ受取フレームと係合させるためのプッシャと
を備えている、装置。
(項目2A)
上記プッシャは、環状プッシャであり、上記ファスナ支持部材は、環状支持フレーム
を含み、該環状支持フレームから遠位方向に上記ファスナが延びている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目3A)
組織を切断するために上記環状プッシャによって前進可能である環状刃をさらに備えている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目4A)
上記ファスナは、該ファスナに沿って軸方向に間隔をあけられている一連のロッキングタブを有することにより、様々な位置にある上記ファスナ受取フレーム内の上記開口のそれぞれと嵌合して可変の係合深さを提供する、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目5A)
上記開口は、可変の係合深さを提供するために、様々な位置にある上記ファスナのそれぞれを係合する一連のロッキング表面を有する、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目6A)
上記ロッキングタブは、複数の実質的に半円形のリブを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目7A)
上記ファスナは、該ファスナ内に形成される長手方向に延びているスロットを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目8A)
上記ロッキングタブは、上記ファスナ受取フレーム内の上記開口に向かう第一の方向への上記ファスナの移動を可能にし、該開口から離れる第二の反対の方向への該ファスナの移動を防止するような角度にされている、複数の突起を含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目9A)
上記ファスナは、薬剤を受け取るための貯蔵器を含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目10A)
上記ファスナ受取フレームは、実質的に平面である外側表面を含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目11A)
上記開口は、第一の深さを有し、上記ファスナのそれぞれは、第一の長さを有し、該第一の長さは該第一の深さよりも短い、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目12A)
外科用ファスニング装置であって、
ファスナ受取フレームであって、該ファスナ受取フレーム内に形成された複数の間隔をあけて離れている開口を含む、ファスナ受取フレームと、
ファスナ支持部材であって、該ファスナ支持部材から延びている複数の間隔をあけて離れている外科用ファスナを含み、該外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織を該外科用ファスナと該ファスナ受取フレームとの間に固定し、該ファスナおよび開口は、該ファスナの2つ以上の深さにおいて、該開口内における該ファスナのロッキング係合を可能にするように構成され、該ファスナの該深さは、該開口の中への該ファスナの前進の前に、事前設定される、ファスナ支持部材と
を備えている、装置。
(項目13A)
上記ファスナ受取フレームは、アンビルに固定された支持構造に取外し可能に固定され、実質的に環状のプッシャは、該ファスナ支持部材を該ファスナ受取フレームとの係合へと前進させる、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目14A)
上記ファスナ支持部材およびファスナ受取フレームは、実質的に環状である、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目15A)
上記ファスナは、該ファスナの長さに沿って軸方向に間隔をあけられている一連のロッキングタブを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目16A)
上記外科用装置は、上記ファスナ支持部材の前進の範囲を決定するための信号を送るために、組織パラメータを決定するために遠位部分に設置されたセンサを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目17A)
上記外科用装置は、上記ファスナ支持部材の前進の範囲を決定するための信号を送るために、装置パラメータを決定するために遠位部分に設置されたセンサを含む、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目18A)
上記複数のファスナは、実質的に一様な間隔をあけて離れている、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目19A)
上記ファスナ受取フレーム、上記ファスナ支持部材および上記複数のファスナは、生物分解性ポリマから作られる、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目20A)
上記ファスナ支持部材は弾性である、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
(項目21A)
上記ファスナ支持部材は弾性である、上記項目のうちのいずれか一項に記載の外科用ファスニング装置。
ファスナ受取フレームであって、その中に形成された複数の間隔をあけて離れている開口を含む、ファスナ受取フレームと、ファスナ支持部材であって、そこから延びている複数の外科用ファスナを含んでいる、ファスナ支持部材とを含む、外科用ファスニング装置。外科用ファスナは、ファスナ受取フレームと嵌合して、その間に組織を固定するために、複数の開口と嵌合可能である。ファスナは、ファスナ受取フレームとファスナ支持部材との間の組織厚に依存して、複数の位置において開口と係合可能である。
16 フランジ部材
20 アンビルアセンブリ
22 アンビル
24 ファスナ保持具部材
26 穿孔
28 保持具
30 ファスナガイド部材
32 ファスナ
40 環状プッシャ
80 フレーム
100 エンドエフェクタ
200 ハンドルアセンブリ
210 トリガー
220 ノブ
240 ハンドル
300 シャフト
Claims (15)
- 外科用ファスニング装置であって、
複数の開口を含むファスナ受取フレームであって、該複数の開口は、間隔をあけて離れているように該ファスナ受取フレーム内に形成されている、ファスナ受取フレームと、
複数の外科用ファスナを含むファスナ支持部材であって、該複数の外科用ファスナは、間隔をあけて離れているように該ファスナ支持部材から延び、該複数の外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織を該外科用ファスナと該ファスナ受取フレームとの間に固定し、該複数のファスナは、該ファスナ受取フレームと該ファスナ支持部材との間の組織厚に依存して、複数の位置において該複数の開口と係合可能である、ファスナ支持部材と、
該ファスナ受取フレームのための保持構造であって、該ファスナ受取フレームは、取外し可能に該保持構造に固定される、保持構造と、
該ファスナ支持部材を前進させて該ファスナ受取フレームと係合させるためのプッシャと
を備え、
該複数の開口のそれぞれは、第一の深さを有し、該複数のファスナのそれぞれは、第一の長さを有し、該第一の長さは、該第一の深さよりも小さい、外科用ファスニング装置。 - 外科用ファスニング装置であって、
複数の開口を含むファスナ受取フレームであって、該複数の開口は、間隔をあけて離れているように該ファスナ受取フレーム内に形成されている、ファスナ受取フレームと、
複数の外科用ファスナを含むファスナ支持部材であって、該複数の外科用ファスナは、間隔をあけて離れているように該ファスナ支持部材から延び、該複数の外科用ファスナは、該複数の開口と係合可能であることにより、該ファスナ受取フレームと嵌合して組織を該外科用ファスナと該ファスナ受取フレームとの間に固定し、該複数のファスナと該複数の開口とは、ファスナの2つ以上の深さにおいて、該複数の開口内における該複数のファスナのロッキング係合を可能にするように構成され、該ファスナの深さは、該複数の開口の中への該複数のファスナの前進の前に、事前設定されている、ファスナ支持部材と
を備え、
該複数の開口のそれぞれは、第一の深さを有し、該複数のファスナのそれぞれは、第一の長さを有し、該第一の長さは、該第一の深さよりも小さい、外科用ファスニング装置。 - 前記プッシャは、環状プッシャであり、前記ファスナ支持部材は、環状支持フレームを含み、該環状支持フレームは、該環状支持フレームから遠位方向に延びている前記ファスナを有する、請求項1に記載の外科用ファスニング装置。
- 組織を切断するために前記環状プッシャによって前進可能である環状刃をさらに備えている、請求項3のいずれか一項に記載の外科用ファスニング装置。
- 前記複数のファスナは、該ファスナに沿って軸方向に間隔をあけられている一連のロッキングタブを有することにより、前記ファスナ受取フレーム内のそれぞれの開口と様々な位置で嵌合して可変の係合深さを提供する、請求項1〜4のいずれか一項に記載の外科用ファスニング装置。
- 前記複数の開口は、可変の係合深さを提供するために、それぞれのファスナと様々な位置で係合する一連のロッキング表面を有する、請求項1〜5のいずれか一項に記載の外科用ファスニング装置。
- 前記複数のファスナは、長手方向に延びているスロットを含み、該スロットは、該複数のファスナ内に形成されている、請求項1〜6のいずれか一項に記載の外科用ファスニング装置。
- 前記ロッキングタブは、複数の突起を含み、該複数の突起は、前記ファスナ受取フレーム内の前記開口に向かう第一の方向への前記ファスナの移動を可能にし、かつ、該開口から離れる第二の反対の方向への該ファスナの移動を防止するように角度が付けられている、請求項5〜7のいずれか一項に記載の外科用ファスニング装置。
- 前記複数のファスナは、薬剤を受け取るための貯蔵器を含む、請求項1〜8のいずれか一項に記載の外科用ファスニング装置。
- 前記ファスナ受取フレームは、アンビルに固定された支持構造に取外し可能に固定され、実質的に環状のプッシャは、前記ファスナ支持部材を該ファスナ受取フレームとの係合へと前進させる、請求項1〜9のいずれか一項に記載の外科用ファスニング装置。
- 前記ファスナ支持部材の前進の範囲を決定するための信号を送るために、組織パラメータを決定するために遠位部分に設置されたセンサをさらに備えている、請求項2〜10のいずれか一項に記載の外科用ファスニング装置。
- 前記ファスナ支持部材の前進の範囲を決定するための信号を送るために、装置パラメータを決定するために遠位部分に設置されたセンサをさらに備えている、請求項2〜10のいずれか一項に記載の外科用ファスニング装置。
- 前記複数のファスナは、実質的に一様な間隔をあけて離れている、請求項1〜12のいずれか一項に記載の外科用ファスニング装置。
- 前記ファスナ受取フレームと前記ファスナ支持部材と前記複数のファスナとは、生物分解性ポリマから作られる、請求項1〜13のいずれか一項に記載の外科用ファスニング装置。
- 前記ファスナ支持部材は、弾性である、請求項1〜14のいずれか一項に記載の外科用ファスニング装置。
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EP2430989B1 (en) | 2014-12-03 |
CA2718091C (en) | 2017-07-04 |
JP2014237028A (ja) | 2014-12-18 |
EP2316353A1 (en) | 2011-05-04 |
AU2016203715A1 (en) | 2016-06-23 |
EP2430989A1 (en) | 2012-03-21 |
AU2016203715B2 (en) | 2018-11-29 |
JP2011092717A (ja) | 2011-05-12 |
EP2316353B1 (en) | 2014-10-15 |
AU2010236033A1 (en) | 2011-05-12 |
US20110095069A1 (en) | 2011-04-28 |
CA2718091A1 (en) | 2011-04-28 |
US9421013B2 (en) | 2016-08-23 |
US8430292B2 (en) | 2013-04-30 |
AU2010236033B2 (en) | 2016-03-03 |
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