JP5848391B2 - 内視鏡縫合システム - Google Patents
内視鏡縫合システム Download PDFInfo
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- JP5848391B2 JP5848391B2 JP2014095799A JP2014095799A JP5848391B2 JP 5848391 B2 JP5848391 B2 JP 5848391B2 JP 2014095799 A JP2014095799 A JP 2014095799A JP 2014095799 A JP2014095799 A JP 2014095799A JP 5848391 B2 JP5848391 B2 JP 5848391B2
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Description
本発明は、内視鏡その他の操作可能なガイド部材と共に自然孔から体内に挿入することができる手術装置に関する。本発明は、人間であるか否か及びその生死を問わずに哺乳動物の組織の縫合を行うために使用することができるが、これらに限定されるものではない。
特許文献2には、器具チャネルが内視鏡とは別体として構成されたものが開示されている。
特許文献3の曲針は、鉗子チャネルに対して同軸の位置に動くものではない。
特許文献4は、外科用縫合器械を内視鏡に固定する取り付け構造体に関するものである。
(1)ガイドチューブ及び/又は内視鏡を、内視鏡及び/又はガイドチューブに連結された縫合装置と共に体内に挿入する段階と、
(2)取り外し可能な針を有する縫合装置の針アームを開く段階と、
(3)所望の縫合部位において針を組織に押し当てる段階と、
(4)縫合装置の針アームを閉じる段階と、
(5)組織を針で穿刺する段階と、
(6)針捕捉装置を用いて針を回収する段階と、
(7)針を組織から抜去する段階と、
(8)針アームを開いて同針アームを組織から抜去する段階と、
(9)針アームを閉じる段階と、
(10)縫合装置を体内から取り出す段階と
を含む。
(1)ガイドチューブを体内に挿入する段階と、
(2)内視鏡に連結された縫合装置をガイドチューブ内及び体内に挿入する段階と、
(3)取り外し可能な針を有する縫合装置の針アームを開く段階と、
(4)組織捕捉器を用いて所望の縫合部位に隣接する組織に係合する段階と、
(5)所望の縫合部位において針を組織に押し当てる段階と、
(6)縫合装置の針アームを閉じる段階と、
(7)組織を針で穿刺する段階と、
(8)針捕捉装置を用いて針を回収する段階と、
(9)針を組織から抜去する段階と、
(10)針アームを開いて同針アームを組織から抜去する段階と、
(11)組織を組織捕捉器から解放する段階と、
(12)針アームを閉じる段階と、
(13)縫合装置を体内から取り出す段階と
を含む。
(1)ガイドチューブを体内に挿入する段階と、
(2)内視鏡に連結された縫合装置をガイドチューブ内に挿入し更に同縫合装置を体内に挿入する段階と、
(3)取り外し可能な針を有する縫合装置の針アームを開く段階と、
(4)所望の縫合部位において針を組織に押し当てる段階と、
(5)縫合装置の針アームを閉じる段階と、
(6)組織を針で穿刺する段階と、
(7)針捕捉装置を用いて針を回収する段階と、
(8)針を組織から抜去する段階と、
(9)針アームを開いて同針アームを組織から抜去する段階と、
(10)針アームを閉じる段階と、
(11)針捕捉装置を用いて内視鏡下で針を針アーム内に挿入する段階と、
(12)必要に応じて(3)乃至(11)の段階を遂行する段階と
を含む。
(1)ガイドチューブを体内に挿入する段階と、
(2)内視鏡に連結された縫合装置をガイドチューブ内に挿入し更に同縫合装置を体内に挿入する段階と、
(3)取り外し可能な針クリップを有する縫合装置の針保持アームを開く段階と、
(4)組織捕捉器を用いて所望の縫合部位に隣接する組織に係合する段階と、
(5)所望の縫合部位において針クリップを組織に押し当てる段階と、
(6)縫合装置の針保持アームを閉じる段階と、
(7)組織を針クリップで穿刺する段階と、
(8)針捕捉装置を用いて針クリップ先端部を捕捉する段階と、
(9)針保持アームを開いて同針保持アームを組織から抜去する段階と、
(10)針クリップを針捕捉装置から解放する段階と、
(11)組織を組織捕捉器から解放する段階と、
(12)針保持アームを閉じる段階と、
(13)縫合装置を体内から取り出す段階と
を含む。
Claims (20)
- 内視鏡及び針と共に用いられ、体外で操作することにより体内で手術を行う手術装置であって、
前記内視鏡が、遠位端面を備える遠位端部と、前記内視鏡と一体に構成され、軸線及び前記遠位端面に対する開口部を有する器具チャネルと、前記針と、を備え、
前記針が、組織穿刺先端部を備え、
前記手術装置が、
前記内視鏡に近接させて前記内視鏡の外側から体内に挿入可能な遠位端部を有する、少なくとも1つの可撓性部材と、
前記内視鏡の遠位端面に配置されたキャップアセンブリと、
を備え、
前記キャップアセンブリが、体外での操作により前記可撓性部材によって作動されるリンク機構と、
前記針を保持するように構成される針保持アームと、
を備え、
前記針保持アームは、前記リンク機構に連結され且つ前記リンク機構により駆動され、前記針を、前記針が組織を貫通する、前記内視鏡の前記遠位端面に向かう第1の方向、及び前記第1の方向とは反対方向の第2の方向、に動かし、
前記針が前記第1の方向に動かされる場合、前記針は、針先端部が前記器具チャネルの軸線に対して傾斜している第1の位置から、針先端部が前記器具チャネルと同軸である第2の位置へ動かされる、
手術装置。 - 前記キャップアセンブリは、チャネル挿入部分を有し、前記チャネル挿入部分は、前記器具チャネル内に挿入され、前記キャップアセンブリの、前記内視鏡の前記遠位端面への保持を助けるようにされている、請求項1に記載の手術装置。
- 前記チャネル挿入部分は、部分的に分離された構造であり、前記部分的に分離された構造は、付勢されて、前記器具チャネルの内壁に対して外向きの力を加える、請求項2に記載の手術装置。
- 前記部分的に分離された構造は、1つ又はそれ以上のスリットによって形成される、請求項2に記載の手術装置。
- 前記キャップアセンブリが、更に、チャネル挿入部分から反対側に延びる組織保護部を含む、請求項1〜4のいずれか1項に記載の手術装置。
- 前記組織保護部が、前記器具チャネル周りのリングの約50度の範囲を取り囲んでいる、請求項5に記載の手術装置。
- 前記組織保護部が、前記針が前記第1の位置から前記第2の位置に動かされると、縫合のために組織を折り畳むようにされている、角度のついた表面を含む表面を有している、請求項5に記載の手術装置。
- 前記キャップアセンブリが、更に、前記針保持アームの上方に延びる針保護部を含む、請求項1〜7のいずれか1項に記載の手術装置。
- 前記針保護部が、前記リンク機構の少なくとも1部の上方に延びる、請求項8に記載の手術装置。
- 前記針が前記第1の位置に保持されている場合、前記針の先端部が、前記針保護部によって保護されている、請求項8に記載の手術装置。
- 前記針が前記第2の位置に保持されている場合、前記針の先端部が、組織保護部を通して配置されている、請求項10に記載の手術装置。
- 前記針が前記第2の位置に保持されている場合、前記針の先端部が、チャネル挿入部分内に配置される、請求項11に記載の手術装置。
- 内視鏡又はガイド部材、及び針と共に用いられ、体外で操作することにより体内で手術を行う手術装置であって、
前記内視鏡又はガイド部材が、遠位端面を備える遠位端部と、軸線及び前記遠位端面に対する開口部とを備え、
前記針が、組織穿刺先端部を備え、
前記手術装置が、
前記内視鏡又はガイド部材内を通過して又はこれらに近接させて体内に挿入可能な遠位端部を有する、少なくとも1つの可撓性部材と、
前記内視鏡又はガイド部材の遠位端面に配置されたキャップアセンブリであって、
前記キャップアセンブリが、チャネル挿入部分を有し、前記チャネル挿入部分が、器具チャネル内に挿入された場合に前記器具チャネルで内視鏡又はガイド部材に力を加え、前記キャップアセンブリを前記内視鏡又はガイド部材の遠位端面で保持する、キャップアセンブリと、
を備え、
前記キャップアセンブリが、体外での操作により作動されるリンク機構と、
前記針を保持するように構成される針保持アームと、
を備え、
前記針保持アームは、前記リンク機構に連結され且つ前記リンク機構により駆動され、前記針を、前記針が組織を貫通する、前記内視鏡又はガイド部材の遠位端部に向かう第1の方向、及び前記第1の方向とは反対方向の第2の方向、に動かし、
前記針が前記第1の方向に動かされる場合、前記針は、針先端部が前記器具チャネルの軸線に対して傾斜している第1の位置から、針先端部が前記器具チャネルと同軸である第2の位置へ動かされる、
手術装置。 - 前記チャネル挿入部分は、部分的に分離された構造であり、前記部分的に分離された構造は、付勢されて、前記器具チャネルの内壁に対して外向きの力を加える、請求項13に記載の手術装置。
- 前記キャップアセンブリが、更に、チャネル挿入ガイド部からチャネル挿入ガイド部の上方に遠位側に延びる組織保護部を含む、請求項13に記載の手術装置。
- 前記組織保護部が、縫合のために組織を折り畳むようにされている、角度のついた表面を含む表面を有している、請求項15に記載の手術装置。
- 前記キャップアセンブリが、更に、前記針保持アームの上方に延びる前記リンク機構の少なくとも1部で延びる、針保護部を含む、請求項15に記載の手術装置。
- 前記針が前記第1の位置に保持されている場合、前記針の先端部が、針保護部によって保護されている、請求項15に記載の手術装置。
- 前記針が前記第1の位置に保持されている場合、前記針の先端部が、針保護部によって保護されており、
前記針が前記第2の位置に保持されている場合、前記針の先端部が、前記組織保護部を通して配置されている、
請求項15に記載の手術装置。 - 前記針が前記第2の位置に保持されている場合、前記針の先端部が、前記チャネル挿入部分内に配置されている、請求項19に記載の手術装置。
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2009
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- 2009-06-16 JP JP2011514752A patent/JP5763531B2/ja active Active
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JP5763531B2 (ja) | 2015-08-12 |
ES2734905T3 (es) | 2019-12-12 |
EP2303144A4 (en) | 2017-05-17 |
US10799232B2 (en) | 2020-10-13 |
EP2303144A1 (en) | 2011-04-06 |
US20090312775A1 (en) | 2009-12-17 |
US11564677B2 (en) | 2023-01-31 |
JP2014193372A (ja) | 2014-10-09 |
US20200163665A1 (en) | 2020-05-28 |
US20200163666A1 (en) | 2020-05-28 |
JP2011524238A (ja) | 2011-09-01 |
US20130096581A1 (en) | 2013-04-18 |
WO2009155287A1 (en) | 2009-12-23 |
US20210093314A1 (en) | 2021-04-01 |
US8287556B2 (en) | 2012-10-16 |
EP2303144B1 (en) | 2019-04-17 |
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