JP5688854B2 - 手術用ステープリング装置 - Google Patents
手術用ステープリング装置 Download PDFInfo
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- JP5688854B2 JP5688854B2 JP2012284800A JP2012284800A JP5688854B2 JP 5688854 B2 JP5688854 B2 JP 5688854B2 JP 2012284800 A JP2012284800 A JP 2012284800A JP 2012284800 A JP2012284800 A JP 2012284800A JP 5688854 B2 JP5688854 B2 JP 5688854B2
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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
-
- 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
- A61B17/07207—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 the staples being applied sequentially
-
- 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
- A61B17/07292—Reinforcements for staple line, e.g. pledgets
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0023—Surgical instruments, devices or methods, e.g. tourniquets disposable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
-
- 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
-
- 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
Description
本願は、米国仮特許出願第60/905,566号(2007年3月6日出願)の優先権の利益を主張する国際(PCT)出願であり、この出願の全開示は本明細書に参考として援用される。
本開示は、手術用装置、例えば、手術用ステープリング装置に関する。より具体的には、本開示は、着脱可能な手術用支持材を含む手術用ステープリング装置、および/または装填ユニット、例えば、単回使用装填ユニット(「SULU」)または使い捨て装填ユニット(「DLU」)のための着脱可能な手術用支持材を含む、内視鏡下手術用ステープリング装置に関する。便宜上、以下、SULUまたはDLUは、「DLU」と呼ばれるが、DLUまたはSULUの一方または両方を含むものと理解されたい。
最初に、対向する顎部構造間に組織が把持または挟持され、次いで、手術用留具によって結合される手術デバイスは、当技術分野において周知である。いくつかの器具では、留具によって結合された組織を切断するために、メスが提供される。留具は、典型的には、手術用ステープルの形態であるが、2部構成ポリマー留具もまた、利用可能である。
本発明は、例えば、以下を提供する。
(項目1)
手術用ステープリング装置であって、
筐体と、
該筐体によって支持されるハンドルと、
該筐体から遠位に延在し、装填ユニットに解除可能に係合するように適合される遠位端を有する、細長い本体と、
該筐体の遠位端に支持可能である装填ユニットであって、該装填ユニットは、
自身の中に複数の手術用留具を有するステープルカートリッジを解除可能に支持するように構成および適合されるカートリッジアセンブリを有するツールアセンブリであって、アンビルアセンブリは該カートリッジアセンブリに対して移動可能に固着されており、該アンビルアセンブリは、アンビルプレートを支持するように構成および適合され、該アンビルプレートおよび該ステープルカートリッジの各々は、細長い長手方向スロットを画定する、ツールアセンブリと、
該アンビルプレートおよび該ステープルカートリッジのうちの少なくとも1つの組織接触表面に解除可能に固着される手術用支持材であって、各手術用支持材は、少なくとも1つの固定材によって、該アンビルアセンブリおよび該カートリッジアセンブリのうちの少なくとも1つに固着される、手術用支持材と、
該ツールアセンブリ内に摺動可能に支持される駆動アセンブリであって、該駆動アセンブリは各細長い長手方向スロット内に摺動可能に配置されるメス刃を含み、近位位置から遠位位置までの該駆動アセンブリの移動によって、該駆動アセンブリの該メス刃は、該少なくとも1つの固定材を切断し、各手術用支持材を該それぞれの少なくとも1つのアンビルアセンブリおよびカートリッジアセンブリから解放する、駆動アセンブリと
を含む、装填ユニットと
を備える、装置。
(項目2)
上記アンビルアセンブリは、それに上記手術用支持材を固着する近位縫合糸を含む、項目1に記載の手術用ステープリング装置。
(項目3)
上記アンビルアセンブリは、それに上記手術用支持材を固着する遠位固定材を含む、項目1に記載の手術用ステープリング装置。
(項目4)
上記カートリッジアセンブリは、それに上記手術用支持材を固着する近位固定材を含む、項目1に記載の手術用ステープリング装置。
(項目5)
上記カートリッジアセンブリは、それに上記手術用支持材を固着する遠位固定材を含む、項目1に記載の手術用ステープリング装置。
(項目6)
上記アンビルアセンブリは、それに上記手術用支持材の近位端を固着する近位固定材と、
それに該手術用支持材の遠位端を固着する遠位固定材とを含み、上記カートリッジアセンブリは、それに該手術用支持材の近位端を固着する近位固定材と、それに該手術用支持材の遠位端を固着する遠位固定材とを含む、項目1に記載の手術用ステープリング装置。
(項目7)
上記アンビルアセンブリおよび上記カートリッジアセンブリの各固定材は、上記アンビルプレートおよび上記ステープルカートリッジの上記それぞれの長手方向スロットに延架する、項目6に記載の手術用ステープリング装置。
(項目8)
上記アンビルアセンブリは、その中に動作可能に支持され、メス縁を画定するメス刃を含み、該アンビルアセンブリの該メス刃は、それの作動に基づいて、該アンビルアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目6に記載の手術用ステープリング装置。
(項目9)
上記アンビルアセンブリの上記メス刃は、該アンビルアセンブリの上記遠位固定材の略近位に位置する第1の位置と、該アンビルアセンブリの該遠位固定材の略遠位に位置する第2の位置とを有し、それによって、該アンビルアセンブリの該遠位固定材を切断する、項目8に記載の手術用ステープリング装置。
(項目10)
上記駆動アセンブリは、該駆動アセンブリの遠位作動に基づいて、該アンビルアセンブリの上記メス刃を上記第1の位置から上記第2の位置まで移動させる、項目9に記載の手術用ステープリング装置。
(項目11)
上記メス刃は、摺動可能および回転可能のうちの1つで上記アンビルアセンブリ内に支持される、項目10に記載の手術用ステープリング装置。
(項目12)
上記カートリッジアセンブリは、その中に動作可能に支持され、メス縁を画定するメス刃を含み、該カートリッジアセンブリの該メス刃は、それの作動に基づいて、該カートリッジアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目6に記載の手術用ステープリング装置。
(項目13)
上記カートリッジアセンブリの上記メス刃は、該カートリッジアセンブリの上記遠位固定材の略近位に位置する第1の位置と、該カートリッジアセンブリの該遠位固定材の略遠位に位置する第2の位置とを有し、それによって、該カートリッジアセンブリの該遠位固定材を切断する、項目12に記載の手術用ステープリング装置。
(項目14)
上記駆動アセンブリは、該駆動アセンブリの遠位作動に基づいて、上記カートリッジアセンブリの上記メス刃を上記第1の位置から上記第2の位置まで移動させる、項目13に記載の手術用ステープリング装置。
(項目15)
上記メス刃は、摺動可能および回転可能のうちの1つで上記カートリッジアセンブリ内に支持される、項目14に記載の手術用ステープリング装置。
(項目16)
上記カートリッジアセンブリおよび上記アンビルアセンブリはそれぞれ、その中に動作可能に支持され、メス縁を画定するメス刃を含み、各メス刃は、それの作動に基づいて、該カートリッジアセンブリおよびアンビルアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目6に記載の手術用ステープリング装置。
(項目17)
手術用ステープリング装置と併用するための装填ユニットであって、
その中に複数の手術用留具を有するステープルカートリッジを解除可能に支持するように構成および適合されるカートリッジアセンブリと、該カートリッジアセンブリに対して移動可能に固着されるアンビルアセンブリとを有するツールアセンブリであって、該アンビルアセンブリは、アンビルプレートを支持するように構成および適合され、該アンビルプレートおよび該ステープルカートリッジの各々は、細長い長手方向スロットを画定する、ツールアセンブリと、
該アンビルプレートおよび該ステープルカートリッジのうちの少なくとも1つの組織接触表面に解除可能に固着される手術用支持材であって、各手術用支持材は、少なくとも1つの固定材によって、該アンビルアセンブリおよび該カートリッジアセンブリのうちの少なくとも1つに固着される、手術用支持材と、
該ツールアセンブリ内に摺動可能に支持される駆動アセンブリであって、該駆動アセンブリは、各細長い長手方向スロット内に摺動可能に配置されるメス刃を含み、近位位置から遠位位置までの移動によって、それの該メス刃は、該少なくとも1つの固定材を切断し、各手術用支持材を該それぞれの少なくとも1つのアンビルアセンブリおよびカートリッジアセンブリから解放する、駆動アセンブリと
を備える、ユニット。
(項目18)
上記アンビルアセンブリは、それに上記手術用支持材を固着する近位縫合糸を含む、項目17に記載の装填ユニット。
(項目19)
上記アンビルアセンブリは、それに上記手術用支持材を固着する遠位固定材を含む、項目17に記載の装填ユニット。
(項目20)
上記カートリッジアセンブリは、それに上記手術用支持材を固着する近位固定材を含む、項目17に記載の装填ユニット。
(項目21)
上記カートリッジアセンブリは、それに上記手術用支持材を固着する遠位固定材を含む、項目17に記載の装填ユニット。
(項目22)
上記アンビルアセンブリは、それに上記手術用支持材の近位端を固着する近位固定材と、それに該手術用支持上記材の遠位端を固着する遠位固定材とを含み、上記カートリッジアセンブリは、それに上記手術用支持材の近位端を固着する近位固定材と、それに該手術用支持材の遠位端を固着する遠位固定材とを含む、項目17に記載の装填ユニット。
(項目23)
上記アンビルアセンブリおよび上記カートリッジアセンブリの各固定材は、上記アンビルプレートおよび上記ステープルカートリッジの上記それぞれの長手方向スロットに延架する、項目22に記載の装填ユニット。
(項目24)
上記アンビルアセンブリは、その中に動作可能に支持され、メス縁を画定するメス刃を含み、該アンビルアセンブリの該メス刃は、それの作動に基づいて、該アンビルアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目22に記載の装填ユニット。
(項目25)
上記アンビルアセンブリの上記メス刃は、該アンビルアセンブリの上記遠位固定材の略近位に位置する第1の位置と、該アンビルアセンブリの該遠位固定材の略遠位に位置する第2の位置とを有し、それによって、該アンビルアセンブリの該遠位固定材を切断する、項目24に記載の装填ユニット。
(項目26)
上記駆動アセンブリは、該駆動アセンブリの遠位作動に基づいて、該アンビルアセンブリの上記メス刃を上記第1の位置から上記第2の位置に移動させる、項目25に記載の装填ユニット。
(項目27)
上記メス刃は、摺動可能および回転可能のうちの1つで上記アンビルアセンブリ内に支持される、項目26に記載の装填ユニット。
(項目28)
上記カートリッジアセンブリは、その中に摺動可能に支持され、かつメス縁を画定するメス刃を含み、該カートリッジアセンブリの該メス刃は、それの作動に基づいて、該カートリッジアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目22に記載の装填ユニット。
(項目29)
上記カートリッジアセンブリの上記メス刃は、該カートリッジアセンブリの上記遠位固定材の略近位に位置する第1の位置と、該カートリッジアセンブリの該遠位固定材の略遠位に位置する第2の位置とを有し、それによって、該カートリッジアセンブリの該遠位固定材を切断する、項目28に記載の装填ユニット。
(項目30)
上記駆動アセンブリは、該駆動アセンブリの遠位作動に基づいて、上記カートリッジアセンブリの上記メス刃を上記第1の位置から上記第2の位置まで移動させる、項目29に記載の装填ユニット。
(項目31)
上記メス刃は、摺動可能および回転可能のうちの1つで上記カートリッジアセンブリ内に支持される、項目30に記載の装填ユニット。
(項目32)
上記カートリッジアセンブリおよび上記アンビルアセンブリはそれぞれ、その中に動作可能に支持され、かつ、メス縁を画定するメス刃を含み、各メス刃は、それの作動に基づいて、該カートリッジアセンブリおよびアンビルアセンブリの上記近位固定材および遠位固定材のうちの少なくとも1つを切断する、項目22に記載の装填ユニット。
(項目33)
手術用ステープリング装置と選択的に併用するための装填ユニットであって、
自身の中に複数の手術用留具を有するステープルカートリッジを解除可能に支持するように構成および適合されるカートリッジアセンブリと、該カートリッジアセンブリに対して移動可能に固着されるアンビルアセンブリとを有するツールアセンブリであって、該アンビルアセンブリは、アンビルプレートを支持するように構成および適合され、該アンビルプレートおよび該ステープルカートリッジは各々、細長い長手方向スロットを画定する、ツールアセンブリと、
該アンビルプレートおよび該ステープルカートリッジの各々の組織接触表面に解除可能に固着される手術用支持材と、
該手術用支持材を該アンビルプレートおよび該ステープルカートリッジの各々に固着する固定材であって、該アンビルアセンブリおよび該カートリッジアセンブリの各々の近位端および遠位端の近傍に位置する、固定材と、
該アンビルアセンブリ内に動作可能に配置されるメス刃であって、該アンビルアセンブリの該メス刃は、該アンビルアセンブリの遠位固定材の近位に位置する第1の位置と、該アンビルアセンブリの該遠位固定材の遠位に位置する第2の位置とを有し、それによって、該アンビルアセンブリの該遠位固定材を切断する、メス刃と、
該カートリッジアセンブリ内に動作可能に配置されるメス刃であって、該カートリッジアセンブリの該メス刃は、該カートリッジアセンブリの遠位固定材の近位に位置する第1の位置と、該カートリッジアセンブリの該遠位固定材の遠位に位置する第2の位置とを有し、それによって、該カートリッジアセンブリの該遠位固定材を切断する、メス刃と、
該ツールアセンブリ内に摺動可能に支持される駆動アセンブリであって、該駆動アセンブリは、各細長い長手方向スロット内に摺動可能に配置されるメス刃を含み、
近位位置から遠位位置までの該駆動アセンブリの移動によって、それの該メス刃は、該アンビルアセンブリおよび該カートリッジアセンブリの各々の近位固定材を切断し、各手術用支持材の近位端を該それぞれの少なくとも1つのアンビルアセンブリおよびカートリッジアセンブリから解放し、
該近位位置から該遠位位置までの該駆動アセンブリの移動によって、該アンビルアセンブリの該メス刃および該カートリッジアセンブリの該メス刃をそれらのそれぞれの第1の位置からそれらのそれぞれの第2の位置まで移動させ、それによって、該アンビルアセンブリおよび該カートリッジアセンブリのそれぞれの遠位固定材を切断し、各手術用支持材の遠位端を該それぞれの少なくとも1つのアンビルアセンブリおよびカートリッジアセンブリから解放する、駆動アセンブリと
を含む、ユニット。
(項目34)
組織接触表面を画定するカートリッジアセンブリと、
組織接触表面を画定するアンビルアセンブリと、
少なくとも1つの固定材によって、該カートリッジアセンブリの該組織接触表面および該アンビルアセンブリの該組織接触表面のうちの少なくとも1つに解除可能に固着される、手術用支持材と
を備える、手術用ステープリング装置。
(項目35)
固定材は、各手術用支持材の近位端および遠位端のうちの少なくとも1つの近傍に載置される、項目34に記載の手術用ステープリング装置。
(項目36)
各固定材は、上記カートリッジアセンブリおよび上記アンビルアセンブリのうちのそれぞれ1つの長手方向軸に対して横向きに延在する、項目34に記載の手術用ステープリング装置。
(項目37)
上記固定材は、縫合糸、ネジ、テザー、ストラップ、バンド、配線、ワイヤ、ケーブル、鋲、固定材、および留具から成る群から選択される、項目36に記載の手術用ステープリング装置。
(項目38)
少なくとも近位固定材は、上記カートリッジアセンブリおよび上記アンビルアセンブリのそれぞれの中に形成されるそれぞれの長手方向メススロットを横切って延在する、項目34に記載の手術用ステープリング装置。
(項目39)
少なくとも遠位固定材は、上記カートリッジアセンブリおよび上記アンビルアセンブリのそれぞれの中に形成されるそれぞれの長手方向メススロットを横切って延在する、項目34に記載の手術用ステープリング装置。
(項目40)
上記固定材は、上記手術用ステープリング装置の発射に基づいて、それぞれの手術用支持材を解除する、項目34に記載の手術用ステープリング装置。
(項目41)
各固定材は、上記手術用ステープリング装置の発射に基づいて、切断されて、上記手術用支持材を解除する、項目38に記載の手術用ステープリング装置。
(項目42)
各固定材は、上記手術用ステープリング装置の発射に基づいて、切断されて、上記手術用支持材を解除する、項目39に記載の手術用ステープリング装置。
(項目43)
上記カートリッジアセンブリおよび上記アンビルアセンブリのそれぞれの中に形成されるそれぞれの長手方向メススロットを通る摺動可能な往復運動のために構成および定寸されるメス刃をさらに備え、該メス刃は、それの遠位への前進に基づいて固定材を切断する、項目34に記載の手術用ステープリング装置。
(項目44)
上記カートリッジアセンブリおよび上記アンビルアセンブリに沿った軸方向変位に対して摺動可能に支持される駆動アセンブリをさらに備え、近位位置から遠位位置までの該駆動アセンブリの移動によって、該カートリッジアセンブリおよび該アンビルアセンブリのうちのそれぞれの1つからの上記手術用支持材の分離をもたらす、項目34に記載の手術用ステープリング装置。
(項目45)
固定材は、各手術用支持材の近位端および遠位端のうちの少なくとも1つの近傍に載置される、項目44に記載の手術用ステープリング装置。
(項目46)
上記駆動アセンブリは、各固定材を直接切断すること、および各固定材を切断させることのうちの少なくとも1つを行なうことにより、上記手術用支持材を上記それぞれのカートリッジアセンブリおよびアンビルアセンブリから解除する、項目45に記載の手術用ステープリング装置。
Claims (2)
- 手術用ステープリング装置であって、該手術用ステープリング装置は、
組織接触表面を画定するカートリッジアセンブリと、
組織接触表面を画定するアンビルアセンブリと、
事前装填され、かつ、少なくとも1つの固定材によって、該カートリッジアセンブリの該組織接触表面および該アンビルアセンブリの該組織接触表面のうちの少なくとも1つに解除可能に固着される手術用支持材であって、該手術用ステープリング装置が発射すると、該手術用支持材が該カートリッジアセンブリの該組織接触表面および該アンビルアセンブリの該組織接触表面のうちの少なくとも1つから解除される、手術用支持材と、
該カートリッジアセンブリおよび該アンビルアセンブリに沿った軸方向変位に対して摺動可能に支持される駆動アセンブリであって、該手術用ステープリング装置が発射すると、該駆動アセンブリが近位位置から遠位位置まで移動することによって、該カートリッジアセンブリおよび該アンビルアセンブリのうちのそれぞれの1つからの該手術用支持材の分離をもたらし、該駆動アセンブリは、メス刃を含む、駆動アセンブリと
を備え、
該カートリッジアセンブリおよび該アンビルアセンブリのうちの少なくとも1つは、メス刃を含み、該メス刃は、動作可能に支持され、かつ、メス縁を画定し、該メス刃は、該メス刃の作動に基づいて少なくとも1つの固定材を切断し、該駆動アセンブリは、該手術用支持材をそれぞれのカートリッジアセンブリおよびアンビルアセンブリから解除するために、該少なくとも1つの固定材が該メス縁によって切断されるようにする、手術用ステープリング装置。 - 固定材は、各手術用支持材の近位端および遠位端のうちの少なくとも1つの近傍に載置される、請求項1に記載の手術用ステープリング装置。
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