JP5638321B2 - 外科用器具およびその外科用器具と共に使用する装填ユニット - Google Patents
外科用器具およびその外科用器具と共に使用する装填ユニット Download PDFInfo
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- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- 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
- 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
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- A61B2017/07214—Stapler heads
- A61B2017/07285—Stapler heads characterised by its cutter
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B17/28—Surgical forceps
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- A61B2017/2945—Curved jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A61B2018/1405—Electrodes having a specific shape
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- A61B2018/1432—Needle curved
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Description
本出願は、2008年9月23日に出願された米国特許出願第12/235,751号の一部継続出願であり、その開示が参考として本明細書中に援用される。
本開示は、概して、組織を外科的に接合する器具に関し、より具体的には、外科用器具と共に使用する湾曲した顎部材と装填ユニットとを有する外科用器具に関する。
本開示は、組織を外科的に接合する外科用器具に関する。外科用器具は、ハンドルアセンブリと、駆動アセンブリと、内視鏡的部分と、一対の顎部材と、動的クランプ部材と、組織停止部とを含む。駆動アセンブリは、ハンドルアセンブリの可動ハンドルと機械的協働状態で配置されている。内視鏡的部分は、第一の長手方向軸を規定する。顎部材の各々は、長手方向軸に対して長手方向に湾曲している。動的クランプ部材は、駆動アセンブリの遠位部分と機械的協働状態で配置され、上ビームと、下ビームと、遠位部分に切断用エッジを有する縦のビームとを含む。動的クランプ部材の少なくとも一部分は、長手方向軸に対して長手方向に湾曲している。組織停止部は、第一の顎部材の遠位部分に隣接して配置され、組織が顎部材から遠位方向に逃げることを防止するように構成されている。
(項目1)
組織を外科的に接合する外科用器具であって、
可動ハンドルを含むハンドルアセンブリと、
該可動ハンドルと機械的協働状態で配置されている駆動アセンブリと、
該ハンドルアセンブリから遠位方向に延び、第一の長手方向軸を規定する内視鏡的部分と、
該内視鏡的部分の遠位端に隣接して配置され、該内視鏡的部分の遠位端から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して湾曲させられており、該顎部材のうちの少なくとも1つは、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該駆動アセンブリの遠位部分と機械的協働状態で配置されている非対称な動的クランプ部材であって、該動的クランプ部材は、該可動ハンドルの少なくとも部分的な作動に応答して該顎部材の長さの少なくとも一部分を通って遠位方向に前進させられ、該動的クランプ部材は、上ビームと、下ビームと、縦の部分とを含み、該縦の部分は、該上ビームと該下ビームとを接続し、かつ切断用エッジを含む、非対称な動的クランプ部材と、
該第一の顎部材の遠位部分に隣接して配置され、組織が該顎部材から逃げることを防止するように構成されている組織停止部と
を備えている、外科用器具。
(項目2)
上記動的クランプ部材の一部分は、上記長手方向軸に対して湾曲させられている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目3)
上記動的クランプ部材の縦の部分は、上記長手方向軸に対して湾曲させられている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目4)
上記動的クランプ部材の上ビームおよび下ビームの各々は、多角形の形状を有する、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目5)
上記動的クランプ部材は、上記縦の部分を通って延びる縦の面に関して非対称である、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目6)
上記動的クランプ部材は、上記縦の部分を通って延びる水平面に関して非対称である、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目7)
上記組織停止部は、該組織停止部が上記顎部材の間に実質的に配置される第一の位置から移動可能であり、かつ、該組織停止部が上記第一の顎部材内に実質的に配置される第二の位置から移動可能である、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目8)
上記組織停止部は、それの第一の位置に向かって付勢部材を介して付勢されている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目9)
上記顎部材の接近は、上記組織停止部を第一の位置から第二の位置に向かって移動させる、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目10)
上記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、上記顎部材が上記開放位置にある状態において、上記第一の顎部材の組織接触表面に対して斜めの角度で配置されている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目11)
上記組織停止部は、少なくとも1つのフィンガを該組織停止部に含み、該少なくとも1つのフィンガは、該組織停止部の近位部分から遠位方向に延び、上記第一の顎部材のリップを係合するように構成されていることにより、上記付勢部材によって与えられる動きの量を制限する、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目12)
上記組織停止部は、上記切断用エッジを受け入れるナイフチャネルを規定する、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目13)
上記切断用エッジは、上記クランプ部材を通る軸に対して中心を外れて面している、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目14)
上記動的クランプ部材の上記下ビームは、上記上ビームよりも幅が広い、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目15)
上記動的クランプ部材の近位の表面から延びる突起部をさらに備えている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目16)
上記下ビームは、上記上ビームよりも厚い、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目17)
外科用器具と解放可能な係合を行うように構成されている装填ユニットであって、該装填ユニットは、
長手方向軸を規定する本体部分であって、該本体部分の近位部分は、該外科用器具の内視鏡的部分と解放可能な係合を行うように構成されている、本体部分と、
該近位の本体部分内で少なくとも部分的に摺動するように配置されている駆動アセンブリと、
該近位の本体部分から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して長手方向に湾曲させられており、該顎部材のうちの少なくとも1つは、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該駆動アセンブリの遠位部分に隣接して配置されている非対称な動的クランプ部材であって、該動的クランプ部材は、上ビームと、下ビームと、縦ビームとを含み、該縦ビームは、該上ビームと該下ビームとを接続し、かつ切断用エッジを該縦ビームの遠位部分に含む、非対称な動的クランプ部材と、
該第一の顎部材の遠位部分に隣接して配置され、組織が該顎部材から遠位方向に逃げることを防止するように構成されている組織停止部と
を備えている、装填ユニット。
(項目18)
上記動的クランプ部材は、上記縦ビームの中心を通って延びる縦の軸に関して非対称である、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目19)
上記動的クランプ部材は、上記縦ビームの縦の中心を通って横に延びる水平軸に関して非対称であり、該水平軸は、上記顎部材が上記接近位置にあるときには、該顎部材の組織接触表面に対して実質的に並行である、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目20)
上記組織停止部は、該組織停止部の少なくとも一部分が上記顎部材の間に配置される第一の位置から移動可能であり、かつ、該組織停止部の少なくとも一部分が、その第一の位置の該顎部材の間に配置され、上記第一の顎部材内に実質的に配置される第二の位置から移動可能である、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目21)
上記組織停止部は、それの第一の位置に向かって付勢部材を介して付勢されている、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目22)
上記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、上記顎部材が上記開放位置にある状態において、上記第一の顎部材の組織接触表面に対して斜めの角度で配置されている、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目23)
上記組織停止部は、上記切断用エッジを受け入れるナイフチャネルを規定する、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目24)
上記切断用エッジは、上記クランプ部材を通る軸に対して中心を外れて面している、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目25)
上記動的クランプ部材の上記下ビームは、上記上ビームよりも幅が広い、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目26)
上記動的クランプ部材の近位の表面から延びる突起部をさらに備えている、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目27)
上記下ビームは、上記上ビームよりも厚い、上記項目のうちのいずれか一項目に記載の装填ユニット。
(項目28)
顎部材を有する外科用器具と共に使用するカートリッジアセンブリであって、該カートリッジアセンブリは、
組織接触表面を含むカートリッジと、
該カートリッジの遠位部分と機械的協働状態で配置され、組織が該顎部材から遠位方向に逃げることを防止するように構成されている組織停止部であって、該組織停止部は、該組織停止部の上表面が該カートリッジの該組織接触表面より上に突出している第一の位置から移動可能であり、かつ、該上表面が該カートリッジの該組織接触表面と実質的に同じ高さである第二の位置から移動可能である、組織停止部と
を備えている、カートリッジアセンブリ。
(項目29)
上記組織停止部は、それの第一の位置に向かって付勢部材を介して付勢されている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目30)
上記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、該組織停止部がその第一の位置にあるときには、該カートリッジの組織接触表面に対して斜めの角度で配置されている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目31)
上記斜めの角度は、約45°と約90°との間にある、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目32)
上記組織停止部は、少なくとも1つのフィンガを該組織停止部に含み、該少なくとも1つのフィンガは、該組織停止部の近位部分から遠位方向に延び、上記カートリッジアセンブリのリップを係合するように構成されていることにより、上記付勢部材によって与えられる動きの量を制限する、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目33)
上記カートリッジは、長手方向に湾曲させられている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目34)
上記組織停止部は、長手方向に湾曲させられている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目35)
上記組織停止部は、その中に配置されているナイフチャネルを含み、該ナイフチャネルは、該組織停止部の近位部分から該組織停止部の遠位部分に向かって延びている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目36)
上記ナイフチャネルは、長手方向に湾曲させられている、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目37)
上記カートリッジは、その中に開口部を含むことにより、上記組織停止部がその第二の位置にあるときには、該組織停止部の近位部分を受け入れる、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目38)
上記組織停止部の遠位部分は、上記カートリッジの遠位部分に対して旋回可能である、上記項目のうちのいずれか一項目に記載のカートリッジアセンブリ。
(項目39)
組織を外科的に接合する外科用器具であって、
可動ハンドルを含むハンドルアセンブリと、
該可動ハンドルと機械的協働状態で配置されている駆動アセンブリと、
該ハンドルアセンブリから遠位方向に延び、第一の長手方向軸を規定する内視鏡的部分と、
該内視鏡的部分の遠位端に隣接して配置され、該内視鏡的部分の遠位端から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して湾曲させられており、該顎部材のうちの少なくとも1つは、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該駆動アセンブリの遠位部分と機械的協働状態で配置されているクランプ部材であって、該クランプ部材は、該可動ハンドルの作動に応答して該顎部材を通って遠位方向に前進させられ、該クランプ部材は、上ビームと、下ビームと、縦の部分とを含み、該縦の部分は、該上ビームと該下ビームとを接続し、かつ切断用エッジを含む、クランプ部材と
を備え、
該一対の顎部材は、カートリッジアセンブリと、アンビルアセンブリとを含み、該カートリッジアセンブリは、組織接触表面と、複数の外科用ステープルと、プッシャとを有し、該アンビルアセンブリは、底の表面を有するアンビルプレートを有し、該カートリッジアセンブリの該組織接触表面は、第一の表面と、第二の表面とを含み、該第一の表面は、該底の表面と共に第一のギャップを規定し、該第二の表面は、該底の表面と共に第二のギャップを規定し、該第一のギャップは、該第二のギャップ未満である、
外科用器具。
(項目40)
上記切断用エッジは、上記クランプ部材を通る軸に対して中心を外れている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目41)
上記クランプ部材は、非対称である、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目42)
上記下ビームは、上記上ビームの高さよりも大きい高さを有する、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目43)
上記下ビームは、上記上ビームよりも幅が広い、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目44)
上記クランプ部材は、突出部を含む、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目45)
上記カートリッジアセンブリの遠位端において組織停止部をさらに備えている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目46)
上記組織停止部は、旋回可能である、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目47)
上記組織停止部は、上記クランプ部材の切断用エッジのためのナイフチャネルを規定する、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目48)
上記プッシャのうちの少なくともいくつかは、第一のプッシャプレートと、第二のプッシャプレートとを含み、該第一のプッシャプレートは、該第二のプッシャプレートからオフセットされている、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目49)
上記プッシャは、2つの外科用ステープルを駆動する二重プッシャと、3つの外科用ステープルを駆動する三重プッシャとを含む、上記項目のうちのいずれか一項目に記載の外科用器具。
(項目50)
上記外科用ステープルのうちの1つは、該外科用ステープルのうちの少なくとも1つの他の第二の脚部の長さと異なる第一の脚部の長さを有する、上記項目のうちのいずれか一項目に記載の外科用器具。
外科用器具が開示される。外科用器具は、ハンドルアセンブリと、駆動アセンブリと、内視鏡的部分と、一対の顎部材と、動的クランプ部材と、組織停止部とを含む。駆動アセンブリは、ハンドルアセンブリの可動ハンドルと機械的協働状態で配置されている。内視鏡的部分は、第一の長手方向軸を規定する。顎部材の各々は、長手方向軸に対して長手方向に湾曲している。動的クランプ部材は、駆動アセンブリの遠位部分と機械的協働状態で配置され、上ビームと、下ビームと、遠位部分に切断用エッジを有する縦のビームとを含む。動的クランプ部材の少なくとも一部分は、長手方向軸に対して長手方向に湾曲している。組織停止部は、第一の顎部材の遠位部分に隣接して配置され、組織が顎部材から遠位方向に逃げることを防止するように構成されている。
12 ハンドルアセンブリ
18 内視鏡的部分
22 可動ハンドル
500 装填ユニット(またはDLU)
504 ツールアセンブリ
506 アンビルアセンブリ
508 カートリッジアセンブリ
518 カートリッジ
560 駆動アセンブリ
604 駆動ビーム
606 動的クランプ部材
606a 縦の支柱(または縦の部分、または縦ビーム)
606b 上ビーム
606c 下ビーム
606d 切断用エッジ(またはナイフ)
700 組織停止部
A−A 長手方向軸
Claims (42)
- 組織を外科的に接合する外科用器具であって、該外科用器具は、
可動ハンドルを含むハンドルアセンブリと、
該可動ハンドルと機械的協働状態で配置されている駆動アセンブリと、
該ハンドルアセンブリから遠位方向に延び、第一の長手方向軸を規定する内視鏡的部分と、
該内視鏡的部分の遠位端に隣接して配置され、該内視鏡的部分の遠位端から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して湾曲させられており、該顎部材のうちの少なくとも一方は、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該駆動アセンブリの遠位部分と機械的協働状態で配置されている非対称な動的クランプ部材であって、該動的クランプ部材は、該可動ハンドルの少なくとも部分的な作動に応答して該顎部材の長さの少なくとも一部分を通って遠位方向に前進させられ、該動的クランプ部材は、上ビームと、下ビームと、縦の部分とを含み、該縦の部分は、該上ビームと該下ビームとを接続し、かつ、切断用エッジを含む、非対称な動的クランプ部材と、
該第一の顎部材の遠位部分に隣接して配置され、組織が該顎部材から逃げることを防止するように構成されている組織停止部と
を備え、
該組織停止部は、該組織停止部が該顎部材の間に実質的に配置される第一の位置から該第一の顎部材に対して旋回可能に移動可能であり、かつ、該組織停止部が該第一の顎部材内に実質的に配置される第二の位置から移動可能であり、
該組織停止部は、該第一の位置に向かって付勢部材を介して付勢されている、外科用器具。 - 前記動的クランプ部材の一部分は、前記長手方向軸に対して湾曲させられている、請求項1に記載の外科用器具。
- 前記動的クランプ部材の縦の部分は、前記長手方向軸に対して湾曲させられている、請求項2に記載の外科用器具。
- 前記動的クランプ部材の上ビームおよび下ビームの各々は、多角形の形状を有する、請求項2に記載の外科用器具。
- 前記動的クランプ部材は、前記縦の部分を通って延びる縦の面に関して非対称である、請求項1に記載の外科用器具。
- 前記動的クランプ部材は、前記縦の部分を通って延びる水平面に関して非対称である、請求項1に記載の外科用器具。
- 前記顎部材の接近は、前記組織停止部を第一の位置から第二の位置に向かって移動させる、請求項1に記載の外科用器具。
- 前記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、前記顎部材が前記開放位置にある状態において、前記第一の顎部材の組織接触表面に対して斜めの角度で配置されている、請求項1に記載の外科用器具。
- 前記組織停止部は、少なくとも1つのフィンガを該組織停止部に含み、該少なくとも1つのフィンガは、該組織停止部の近位部分から遠位方向に延び、前記第一の顎部材のリップを係合するように構成されていることにより、前記付勢部材によって与えられる動きの量を制限する、請求項1に記載の外科用器具。
- 前記組織停止部は、前記切断用エッジを受け入れるナイフチャネルを規定する、請求項1に記載の外科用器具。
- 前記切断用エッジは、前記クランプ部材を通る軸に対して中心を外れて面している、請求項10に記載の外科用器具。
- 前記動的クランプ部材の前記下ビームは、前記上ビームよりも幅が広い、請求項1に記載の外科用器具。
- 前記動的クランプ部材の近位の表面から延びる突起部をさらに備えている、請求項1に記載の外科用器具。
- 前記下ビームは、前記上ビームよりも厚い、請求項1に記載の外科用器具。
- 外科用器具と解放可能な係合を行うように構成されている装填ユニットであって、該装填ユニットは、
長手方向軸を規定する本体部分であって、該本体部分の近位部分は、該外科用器具の内視鏡的部分と解放可能な係合を行うように構成されている、本体部分と、
該近位の本体部分内で少なくとも部分的に摺動するように配置されている駆動アセンブリと、
該近位の本体部分から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して長手方向に湾曲させられており、該顎部材のうちの少なくとも一方は、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該駆動アセンブリの遠位部分に隣接して配置されている非対称な動的クランプ部材であって、該動的クランプ部材は、上ビームと、下ビームと、縦ビームとを含み、該縦ビームは、該上ビームと該下ビームとを接続し、かつ、切断用エッジを該縦ビームの遠位部分に含む、非対称な動的クランプ部材と、
該第一の顎部材の遠位部分に隣接して配置され、組織が該顎部材から遠位方向に逃げることを防止するように構成されている組織停止部と
を備え、
該組織停止部は、該組織停止部が該顎部材の間に実質的に配置される第一の位置から該第一の顎部材に対して旋回可能に移動可能であり、かつ、該組織停止部が該第一の顎部材内に実質的に配置される第二の位置から移動可能であり、
該組織停止部は、該第一の位置に向かって付勢部材を介して付勢されている、装填ユニット。 - 前記動的クランプ部材は、前記縦ビームの中心を通って延びる縦の軸に関して非対称である、請求項15に記載の装填ユニット。
- 前記動的クランプ部材は、前記縦ビームの縦の中心を通って横に延びる水平軸に関して非対称であり、該水平軸は、前記顎部材が前記接近位置にあるときには、該顎部材の組織接触表面に対して実質的に並行である、請求項15に記載の装填ユニット。
- 前記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、前記顎部材が前記開放位置にある状態において、前記第一の顎部材の組織接触表面に対して斜めの角度で配置されている、請求項15に記載の装填ユニット。
- 前記組織停止部は、前記切断用エッジを受け入れるナイフチャネルを規定する、請求項15に記載の装填ユニット。
- 前記切断用エッジは、前記クランプ部材を通る軸に対して中心を外れて面している、請求項19に記載の装填ユニット。
- 前記動的クランプ部材の前記下ビームは、前記上ビームよりも幅が広い、請求項15に記載の装填ユニット。
- 前記動的クランプ部材の近位の表面から延びる突起部をさらに備えている、請求項15に記載の装填ユニット。
- 前記下ビームは、前記上ビームよりも厚い、請求項15に記載の装填ユニット。
- 顎部材を有する外科用器具と共に使用するカートリッジアセンブリであって、該カートリッジアセンブリは、
組織接触表面を含むカートリッジと、
該カートリッジの遠位部分と機械的協働状態で配置され、組織が該顎部材から遠位方向に逃げることを防止するように構成されている組織停止部であって、該組織停止部は、該組織停止部が該顎部材の間に実質的にあり、かつ、該組織停止部の上表面が該カートリッジの該組織接触表面より上に突出している第一の位置から第一の顎部材に対して旋回可能に移動可能であり、かつ、該組織停止部が該第一の顎部材内に実質的にあり、かつ、該上表面が該カートリッジの該組織接触表面と実質的に同じ高さである第二の位置から移動可能である、組織停止部と
を備え、
該組織停止部は、該第一の位置に向かって付勢部材を介して付勢されている、カートリッジアセンブリ。 - 前記組織停止部は、該組織停止部の近位部分に隣接して配置されている停止部分を含み、該停止部分は、該組織停止部がその第一の位置にあるときには、該カートリッジの組織接触表面に対して斜めの角度で配置されている、請求項24に記載のカートリッジアセンブリ。
- 前記斜めの角度は、約45°と約90°との間にある、請求項25に記載のカートリッジアセンブリ。
- 前記組織停止部は、少なくとも1つのフィンガを該組織停止部に含み、該少なくとも1つのフィンガは、該組織停止部の近位部分から遠位方向に延び、前記カートリッジアセンブリのリップを係合するように構成されていることにより、前記付勢部材によって与えられる動きの量を制限する、請求項24に記載のカートリッジアセンブリ。
- 前記カートリッジは、長手方向に湾曲させられている、請求項24に記載のカートリッジアセンブリ。
- 前記組織停止部は、長手方向に湾曲させられている、請求項28に記載のカートリッジアセンブリ。
- 前記組織停止部は、その中に配置されているナイフチャネルを含み、該ナイフチャネルは、該組織停止部の近位部分から該組織停止部の遠位部分に向かって延びている、請求項24に記載のカートリッジアセンブリ。
- 前記ナイフチャネルは、長手方向に湾曲させられている、請求項30に記載のカートリッジアセンブリ。
- 前記カートリッジは、その中に開口部を含むことにより、前記組織停止部がその第二の位置にあるときには、該組織停止部の近位部分を受け入れる、請求項24に記載のカートリッジアセンブリ。
- 組織を外科的に接合する外科用器具であって、該外科用器具は、
可動ハンドルを含むハンドルアセンブリと、
該可動ハンドルと機械的協働状態で配置されている駆動アセンブリと、
該ハンドルアセンブリから遠位方向に延び、第一の長手方向軸を規定する内視鏡的部分と、
該内視鏡的部分の遠位端に隣接して配置され、該内視鏡的部分の遠位端から概して遠位方向に延びている一対の顎部材であって、該顎部材の各々は、該長手方向軸に対して湾曲させられており、該顎部材のうちの少なくとも一方は、開放位置と、身体組織を該顎部材の間に係合する接近位置との間を他方に対して移動可能であり、該一対の顎部材は、第一の顎部材と第二の顎部材とを含む、一対の顎部材と、
該第一の顎部材の遠位部分に隣接して配置され、組織が該顎部材から逃げることを防止するように構成されている組織停止部であって、該組織停止部は、該組織停止部が該顎部材の間に実質的に配置される第一の位置から該第一の顎部材に対して旋回可能に移動可能であり、かつ、該組織停止部が該第一の顎部材内に実質的に配置される第二の位置から移動可能であり、該組織停止部は、該第一の位置に向かって付勢部材を介して付勢されている、組織停止部と、
該駆動アセンブリの遠位部分と機械的協働状態で配置されているクランプ部材であって、該クランプ部材は、該可動ハンドルの作動に応答して該顎部材を通って遠位方向に前進させられ、該クランプ部材は、上ビームと、下ビームと、縦の部分とを含み、該縦の部分は、該上ビームと該下ビームとを接続し、かつ、切断用エッジを含む、クランプ部材と
を備え、
該一対の顎部材は、カートリッジアセンブリと、アンビルアセンブリとを含み、該カートリッジアセンブリは、組織接触表面と、複数の外科用ステープルと、プッシャとを有し、該アンビルアセンブリは、底の表面を有するアンビルプレートを有し、該カートリッジアセンブリの該組織接触表面は、第一の表面と、第二の表面とを含み、該第一の表面は、該底の表面と共に第一のギャップを規定し、該第二の表面は、該底の表面と共に第二のギャップを規定し、該第一のギャップは、該第二のギャップ未満である、
外科用器具。 - 前記切断用エッジは、前記クランプ部材を通る軸に対して中心を外れている、請求項33に記載の外科用器具。
- 前記クランプ部材は、非対称である、請求項34に記載の外科用器具。
- 前記下ビームは、前記上ビームの高さよりも大きい高さを有する、請求項35に記載の外科用器具。
- 前記下ビームは、前記上ビームよりも幅が広い、請求項35に記載の外科用器具。
- 前記クランプ部材は、突出部を含む、請求項35に記載の外科用器具。
- 前記組織停止部は、前記クランプ部材の切断用エッジのためのナイフチャネルを規定する、請求項36に記載の外科用器具。
- 前記プッシャのうちの少なくともいくつかは、第一のプッシャプレートと、第二のプッシャプレートとを含み、該第一のプッシャプレートは、該第二のプッシャプレートからオフセットされている、請求項33に記載の外科用器具。
- 前記プッシャは、2つの外科用ステープルを駆動する二重プッシャと、3つの外科用ステープルを駆動する三重プッシャとを含む、請求項40に記載の外科用器具。
- 前記外科用ステープルのうちの1つは、該外科用ステープルのうちの少なくとも1つの他の第二の脚部の長さと異なる第一の脚部の長さを有する、請求項33に記載の外科用器具。
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US12/553,174 US7988028B2 (en) | 2008-09-23 | 2009-09-03 | Surgical instrument having an asymmetric dynamic clamping member |
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EP (1) | EP2292155B1 (ja) |
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2009
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CA2713615A1 (en) | 2011-03-03 |
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AU2010212398A1 (en) | 2011-03-17 |
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EP2292155A2 (en) | 2011-03-09 |
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AU2010212398B2 (en) | 2013-09-19 |
US20110264137A1 (en) | 2011-10-27 |
US20120325891A1 (en) | 2012-12-27 |
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US20100072258A1 (en) | 2010-03-25 |
US7988028B2 (en) | 2011-08-02 |
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