JP5721414B2 - 外科用クリップ適用具 - Google Patents
外科用クリップ適用具 Download PDFInfo
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- JP5721414B2 JP5721414B2 JP2010273070A JP2010273070A JP5721414B2 JP 5721414 B2 JP5721414 B2 JP 5721414B2 JP 2010273070 A JP2010273070 A JP 2010273070A JP 2010273070 A JP2010273070 A JP 2010273070A JP 5721414 B2 JP5721414 B2 JP 5721414B2
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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
- A61B17/10—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
- A61B17/068—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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
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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
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00407—Ratchet means
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0803—Counting the number of times an instrument is used
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
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Description
本出願は、2009年12月9日出願の米国仮特許出願第61/285,006号の利益と優先権を主張し、該仮特許出願の全体内容が本明細書において参照により援用される。
本開示は、外科用器具に関する。より詳細には、本開示は、外科手術の期間中に体組織および管にクリップを適用するための複数のクリップを有する外科用クリップ適用具に関する。
外科用クリップ適用具は本分野において公知であり、従来の体組織および管の縫合に対する代替手段を提示することによって、外科医の間で人気が増している。典型的な器具は、Greenらに対する特許文献1およびBurbank,IIIらに対する特許文献2において開示されている。これらの器具は一般的に複数のクリップを提供し、複数のクリップは、器具内に格納され、器具の近位の端にあるハンドルを開閉することによって、器具の遠位の端にあるあご構造に逐次的に供給される。ハンドルが閉じられると、あごはあご部材の間に位置したクリップを加圧変形させるように閉じ、あごが加圧変形されたクリップを開放するように開かれると、新たなクリップが一連のクリップからあごの間にある位置に供給される。このプロセスは、一連のクリップ中のすべてのクリップが使用されるまで繰り返される。
外科用クリップ適用具であって、
筐体と、
該筐体に旋回可能に接続されている少なくとも1つのハンドルと、
該筐体から遠位に延伸しているチャネルアセンブリと、
クリップキャリア内に装填されている複数のクリップと、
該筐体内および該チャネルアセンブリ内に並進可能に支持されているドライブチャネルであって、該ドライブチャネルは、該少なくとも1つのハンドルが作動すると並進される、ドライブチャネルと、
該ハウジング内に支持されているカウンタ機構であって、該カウンタ機構は、該筐体を通して視認可能な印を含み、該印は、該クリップ適用具内に装填されている複数のクリップに対応し、該印は、該クリップ適用具の毎回の発射の結果、該複数のクリップのうちの残留しているクリップの量が低減すると減算する、外科用クリップ適用具。
上記カウンタ機構は、上記筐体内に回転可能に支持され、該カウンタ機構が単一の方向に回転することを可能にする単方向クラッチ部材を含む、項目1に記載のクリップ適用具。
上記カウンタ機構は、
上記筐体内に回転可能に支持されているカウンタダイヤルであって、該カウンタダイヤルは該カウンタダイヤルの上記印を含む、カウンタダイヤルと、
該カウンタダイヤルに動作可能に接続されているカウンタクラッチであって、該カウンタクラッチの第1の方向の回転は、該カウンタダイヤルの該第1の方向の回転を生じ、該カウンタクラッチの第2の方向の回転は、該カウンタダイヤルの回転を生じない、カウンタクラッチと
を含む、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタ機構は、上記カウンタダイヤルと動作可能に係合されているラッチ部材を含み、該ラッチ部材は、該カウンタダイヤルが上記第1の方向に回転することを可能にし、該カウンタ機構が該第1の方向と逆の方向に回転することを禁止する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタダイヤルは、該カウンタダイヤルの外周に形成された複数の溝を含み、上記ラッチ部材は、該カウンタダイヤルの該複数の溝と係合するように付勢されている弾性の指を含む、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタクラッチは、上記カウンタダイヤル内に規定された開口部内に同心で回転可能に入れ子に収められ、該カウンタクラッチは、該カウンタダイヤルの該開口部の周囲の表面に形成された単方向の歯と係合するために、該カウンタクラッチから延伸している少なくとも1つの弾性の指を含む、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記ドライブチャネルは、該ドライブチャネル内に斜めのスロットを規定し、上記カウンタクラッチは、該カウンタクラッチの表面から延伸し、かつ、該ドライブチャネルの該斜めのスロット内にスライド可能に配置されているクラッチピンを含み、上記カウンタ機構に対して第1の方向に該ドライブチャネルが並進することは、該ドライブチャネルの該斜めのスロットによって該クラッチピンがカム作用され、それによって該カウンタクラッチを該第1の方向に回転させ、該カウンタ機構に対して第2の方向に該ドライブチャネルが並進することは、該ドライブチャネルの該斜めのスロットによって該クラッチピンがカム作用され、それによって該カウンタクラッチを該第2の方向に回転させる、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタ機構は、上記カウンタダイヤルと動作可能に係合されているラッチ部材を含み、該ラッチ部材は、該カウンタダイヤルが上記第1の方向に回転することを可能にし、該カウンタ機構が該第1の方向と逆の方向に回転することを禁止する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタダイヤルは、該カウンタダイヤルの外周に形成された複数の溝を含み、上記ラッチ部材は、該カウンタダイヤルの該複数の溝と係合するように付勢されている弾性の指を含む、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタ機構は、
ロックアウト溝を規定しているカウンタダイヤルであって、該ロックアウト溝は、該カウンタダイヤルの外周の縁に形成されている、カウンタダイヤルと、
上記筐体内に支持されているロックアウトであって、該ロックアウトは、該ロックアウトの第1の捕捉部が該カウンタダイヤルの外周の縁に対して係合するように付勢されている、ロックアウトと
を含み、
該カウンタダイヤルが回転されて、該カウンタダイヤルの該ロックアウト溝が該ロックアウトの該第1の捕捉部と契合するようになった場合、該ロックアウトの該第1の捕捉部は、該ロックアウト溝の中へ推進され、それによって該カウンタダイヤルが逆方向に回転することを防止する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記ロックアウトは第2の捕捉部を含み、該第2の捕捉部は、該ロックアウトの上記第1の捕捉部が上記カウンタダイヤルの上記ロックアウト溝の中へ移動される場合、上記クリップ適用具の並進部材の進路の中へ移動し、それによって該クリップ適用具の該並進部材の並進を禁止する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタダイヤルの上記ロックアウト溝は、上記複数のクリップのうちの最後のクリップが発射された場合、上記ロックアウトの上記第1の捕捉部と契合するように移動する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記カウンタダイヤルの上記ロックアウト溝は、上記カウンタ機構の上の印に関連付けられ、該印は、上記最後のクリップが発射されたことを指示する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記複数のクリップのうちの上記最後のクリップが発射されたことを指示する、上記カウンタ機構の上の上記印は、数「零」によって表象される、上記項目のうちのいずれか1項に記載のクリップ適用具。
ラチェット機構であって、
上記筐体内に旋回可能に支持されているラチェット歯止と、
上記並進部材上に提供されているラック部材と
をさらに備え、
該ラック部材は、該ラチェット歯止との位置を合わせて動作し、該ラック部材は、該並進部材が並進する場合、該ラチェット歯止を横切って並進する、上記項目のうちのいずれか1項に記載のクリップ適用具。
上記ラチェット機構は、上記ラック部材が完全に並進し終わっていない場合、リセットすることが防止される、上記項目のうちのいずれか1項に記載のクリップ適用具。
外科用クリップ適用具は、筐体と、筐体に旋回可能に接続された少なくとも1つのハンドルと、筐体から遠位に延伸しているチャネルアセンブリと、クリップキャリア内に装填された複数のクリップと、筐体内およびチャネルアセンブリ内に並進可能に支持されたドライブチャネルと、少なくとも1つのハンドルが作動されると並進されるドライブチャネルと、筐体内に支持されたカウンタ機構とを含み、カウンタ機構は筐体を通して視認可能な印を含み、ここで印は、クリップ適用具内に装填されたクリップの量に対応し、印は、クリップ適用具の毎回の発射の結果、複数のクリップのうちの残留しているクリップの量が低減すると減算するように提供される。
本開示に従った外科用クリップ適用具の実施形態は、ここで図面を参照して詳細に記載され、図面において、同一の参照番号は同様または同一の構造要素を識別する。図面に示され、および以下の記載を通して記載されるように、外科用器具上の相対的な位置を指す場合に伝統的であるように、「近位の」の用語は、使用者により近接した装置の端を指し、「遠位の」の用語は、使用者から遠く離れた装置の端を指す。
102 ハンドルアセンブリ
104 筐体
104a 筐体の上位の半分
104b 筐体の下位の半分
104c 窓
104d ハンドル旋回軸支柱
106 ハンドル
106a 穴
106b 旋回軸支点
108 チャネルアセンブリ
110 あごアセンブリ
122 リンク部材
124 ドライブピン
130 カートリッジカバー
132 外側または下位のチャネル
140 ドライブチャネル
140a 斜めのスロット
141 ラチェットラック部材
141a ラチェット歯
141c ノッチ
142 ラチェット歯止
144 ラチェット機構
145 歯止ばね
146 ロックアウト
146b、146c 捕捉部
147 付勢部材
148 インジケータ
155 動き増倍システム
160 クリッププッシャバー
162 スタビライザ
170 クリップキャリア
174 クリップフォロワ
179 くさびプレート旋回アーム
180 くさびプレート
190 機械的カウンタ機構
192 カウンタダイヤル
192b 印
192d 開口部
192e 単方向の歯
192f、192f’、192g 溝
194 カウンタクラッチ
194b、194c、196a 弾性の指
194d クラッチピン
196 ラッチ部材
Claims (14)
- 外科用クリップ適用具であって、該外科用クリップ適用具は、
筐体と、
該筐体に旋回可能に接続されている少なくとも1つのハンドルと、
該筐体から遠位に延伸しているチャネルアセンブリと、
クリップキャリア内に装填されている複数のクリップと、
該筐体内および該チャネルアセンブリ内に並進可能に支持されているドライブチャネルであって、該ドライブチャネルは、該少なくとも1つのハンドルが作動すると並進される、ドライブチャネルと、
該筐体内に支持されているカウンタ機構と
を含み、
該カウンタ機構は、
該筐体内に回転可能に支持されたカウンタダイヤルと、
該ドライブチャネルと該カウンタダイヤルとに動作可能に接続されているカウンタクラッチであって、該カウンタクラッチの第1の回転方向の回転は、該カウンタダイヤルの該第1の回転方向の回転を生じさせる結果となり、該カウンタクラッチの第2の回転方向の回転は、該カウンタダイヤルの回転を生じさせない結果となり、該カウンタクラッチは、該カウンタダイヤル内に規定された開口部内に同心で回転可能に入れ子に収められており、該カウンタ機構に対して第1の並進方向に該ドライブチャネルが並進することは、該第1の回転方向に該カウンタクラッチが回転することを直接的に引き起こし、該カウンタ機構に対して第2の並進方向に該ドライブチャネルが並進することは、該第2の回転方向に該カウンタクラッチが回転することを直接的に引き起こす、カウンタクラッチと、
該カウンタダイヤル上に配置されている印であって、該筐体を通して視認可能な印と
を含み、
該印は、該クリップ適用具内に装填されているクリップの量に対応し、該クリップ適用具の毎回の発射の結果、該複数のクリップのうちの残留しているクリップの量が低減すると、該印が減算する、外科用クリップ適用具。 - 前記カウンタ機構は、前記カウンタダイヤルと動作可能に係合されているラッチ部材を含み、該ラッチ部材は、該カウンタダイヤルが前記第1の回転方向に回転することを可能にし、かつ、該カウンタ機構が該第1の回転方向と逆の方向に回転することを禁止する、請求項1に記載のクリップ適用具。
- 前記カウンタダイヤルは、該カウンタダイヤルの外周に形成された複数の溝を含み、前記ラッチ部材は、該カウンタダイヤルの該複数の溝と係合するように付勢されている弾性の指を含む、請求項2に記載のクリップ適用具。
- 前記カウンタクラッチは、前記カウンタダイヤルの前記開口部の周囲の表面に形成された単方向の歯と係合するために、該カウンタクラッチから延伸している少なくとも1つの弾性の指を含む、請求項1に記載のクリップ適用具。
- 前記ドライブチャネルは、該ドライブチャネル内に斜めのスロットを規定し、前記カウンタクラッチは、該カウンタクラッチの表面から延伸し、かつ、該ドライブチャネルの該斜めのスロット内にスライド可能に配置されているクラッチピンを含み、前記カウンタ機構に対して前記第1の並進方向に該ドライブチャネルが並進することは、該ドライブチャネルの該斜めのスロットによって該クラッチピンがカム作用され、それによって該カウンタクラッチを前記第1の回転方向に回転させ、該カウンタ機構に対して前記第2の並進方向に該ドライブチャネルが並進することは、該ドライブチャネルの該斜めのスロットによって該クラッチピンがカム作用され、それによって該カウンタクラッチを前記第2の回転方向に回転させる、請求項4に記載のクリップ適用具。
- 前記カウンタ機構は、前記カウンタダイヤルと動作可能に係合されているラッチ部材を含み、該ラッチ部材は、該カウンタダイヤルが前記第1の回転方向に回転することを可能にし、かつ、該カウンタ機構が該第1の回転方向と逆の方向に回転することを禁止する、請求項5に記載のクリップ適用具。
- 前記カウンタダイヤルは、該カウンタダイヤルの外周に形成された複数の溝を含み、前記ラッチ部材は、該カウンタダイヤルの該複数の溝と係合するように付勢されている弾性の指を含む、請求項6に記載のクリップ適用具。
- 前記カウンタ機構は、
前記カウンタダイヤルの外周の縁に形成されているロックアウト溝と、
前記筐体内に支持されているロックアウトであって、該ロックアウトは、該ロックアウトの第1の捕捉部が該カウンタダイヤルの外周の縁に対して係合するように付勢されている、ロックアウトと
を含み、
該カウンタダイヤルが回転されて、該カウンタダイヤルの該ロックアウト溝が該ロックアウトの該第1の捕捉部と契合するようになった場合、該ロックアウトの該第1の捕捉部は、該ロックアウト溝の中へ推進され、それによって該カウンタダイヤルが逆方向に回転することを防止する、請求項1に記載のクリップ適用具。 - 前記ロックアウトは、第2の捕捉部を含み、該第2の捕捉部は、該ロックアウトの前記第1の捕捉部が前記カウンタダイヤルの前記ロックアウト溝の中へ移動される場合、前記クリップ適用具の並進部材の進路の中へ移動し、それによって該クリップ適用具の該並進部材の並進を禁止する、請求項8に記載のクリップ適用具。
- 前記カウンタダイヤルの前記ロックアウト溝は、前記複数のクリップのうちの最後のクリップが発射された場合、前記ロックアウトの前記第1の捕捉部と契合するように移動する、請求項9に記載のクリップ適用具。
- 前記カウンタダイヤルの前記ロックアウト溝は、前記カウンタ機構の上の印に関連付けられ、該印は、前記最後のクリップが発射されたことを示す、請求項10に記載のクリップ適用具。
- 前記複数のクリップのうちの前記最後のクリップが発射されたことを示す前記カウンタ機構の上の前記印は、数「零」によって表象される、請求項11に記載のクリップ適用具。
- ラチェット機構をさらに含み、
該ラチェット機構は、
前記筐体内に旋回可能に支持されているラチェット歯止と、
前記並進部材上に提供されているラック部材と
を含み、
該ラック部材は、該ラチェット歯止との位置を合わせて動作し、該ラック部材は、該並進部材が並進する場合、該ラチェット歯止を横切って並進する、請求項9に記載のクリップ適用具。 - 前記ラチェット機構は、前記ラック部材が完全に並進し終わっていない場合、リセットすることが防止される、請求項13に記載のクリップ適用具。
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US12/939,296 US9186136B2 (en) | 2009-12-09 | 2010-11-04 | Surgical clip applier |
US12/939,296 | 2010-11-04 |
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EP (2) | EP2471470B1 (ja) |
JP (2) | JP5721414B2 (ja) |
CN (1) | CN102090911B (ja) |
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- 2010-11-12 CA CA2720558A patent/CA2720558A1/en not_active Abandoned
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JP2011120908A (ja) | 2011-06-23 |
US20160030045A1 (en) | 2016-02-04 |
US10758234B2 (en) | 2020-09-01 |
CN102090911B (zh) | 2014-12-03 |
EP2332471A1 (en) | 2011-06-15 |
CN102090911A (zh) | 2011-06-15 |
US20110137323A1 (en) | 2011-06-09 |
EP2332471B1 (en) | 2013-05-01 |
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