JP5902645B2 - 関節駆動式手術器具及びその操作方法 - Google Patents
関節駆動式手術器具及びその操作方法 Download PDFInfo
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
- A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00318—Steering mechanisms
- A61B2017/00323—Cables or rods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2901—Details of shaft
- A61B2017/2908—Multiple segments connected by articulations
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B17/2909—Handles
- A61B2017/291—Handles the position of the handle being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2931—Details of heads or jaws with releasable head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320044—Blunt dissectors
-
- 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
- A61B2090/0817—Spatulas or spatula like extensions
-
- 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
- A61B90/70—Cleaning devices specially adapted for surgical instruments
- A61B2090/701—Cleaning devices specially adapted for surgical instruments for flexible tubular instruments, e.g. endoscopes
Description
12 ルーメン
14 近位リンク(近位関節駆動部)
15 遠位リンク(遠位関節駆動部)
16 ハンドピース
24 トリガー
26 近位ナックル
28 遠位ナックル
30 チップ取付部
32 ハンドル
34 ノーズピース
38 ハンドル回転解除ボール
40 関節駆動ロックボタン
42 ルアー
43 ルアーキャップ
44 ケーブル(作動ケーブル)
44A 作動部
44B リターン部
46 近位部ナックル(ケーブルルーター)
47 近位ヒンジピンナックル(ケーブルルーター)
48 ルーメンナックル(ケーブルルーター)
50 ヒンジピン(近位ヒンジピン)
52 遠位関節駆動部ナックル(ケーブルルーター)
54 遠位ヒンジピンナックル(ケーブルルーター)
56 遠位部ナックル(ケーブルルーター)
58 ヒンジピン(遠位ヒンジピン)
60 アジャスター(調整機構)
62 ロッキングバー
247A 近位作動ヒンジピンプーリ(近位プーリアッセンブリ、第1近位プーリ)
247B 近位戻りヒンジピンプーリ(近位プーリアッセンブリ、第2近位プーリ)
254A 遠位作動ヒンジピンプーリ(遠位プーリアッセンブリ、第1遠位プーリ)
254B 遠位戻りヒンジピンプーリ(遠位プーリアッセンブリ、第2遠位プーリ)
Claims (20)
- 近位端と遠位端を有するルーメン;
このルーメンの近位端に固定された、アクチュエータを含むハンドピース;
近位端と遠位端を有し、該近位端が前記ルーメンの遠位端に、前記ルーメンの長手方向軸に対して略垂直な方向に延びる近位ヒンジピンを介して回動自在に取り付けられた近位関節駆動部;
近位端と遠位端を有し、該近位端が前記近位関節駆動部の遠位端に、前記ルーメンの長手方向軸に対して略垂直な方向に延びる遠位ヒンジピンを介して回動自在に取り付けられた遠位関節駆動部;
前記アクチュエータから前記ルーメンを通って前記近位関節駆動部と前記遠位関節駆動部の内部に延びる作動ケーブル;及び
近位端に、前記近位ヒンジピンを中心に回転可能で前記作動ケーブルが巻かれた近位プーリアッセンブリを有し、遠位端に、前記遠位ヒンジピンを中心に回転可能で前記作動ケーブルが巻かれた遠位プーリアッセンブリを有するケーブルルーター;を備え、
前記近位関節駆動部は、前記近位ヒンジピンを介して、前記ルーメンの長手方向軸に対して約0°から90°の範囲で回動自在であること;
前記遠位関節駆動部は、前記遠位ヒンジピンを介して、前記近位関節駆動部の長手方向軸に対して約0°から90°の範囲で回動自在であること;及び
前記近位関節駆動部と前記遠位関節駆動部の回動自在性により、前記遠位関節駆動部は、前記ルーメンの長手方向軸に対して約0°から180°の範囲で回動自在であること;
を特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記作動ケーブルは、前記近位プーリアッセンブリの周りに約360°巻かれていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位関節駆動部を前記ルーメンに対して斜めとなる位置へ回動させるために前記作動ケーブルに張力がかかっている間は、該作動ケーブルが前記近位プーリアッセンブリに当接して動かされ、該近位プーリアッセンブリを回転させることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位プーリアッセンブリの外周には、前記作動ケーブルを巻くための螺旋状溝が備えられていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記作動ケーブルは、前記遠位プーリアッセンブリの周りに約360°巻かれていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記遠位プーリアッセンブリの外周には、前記作動ケーブルを巻くための螺旋状溝が備えられていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
さらに、前記遠位関節駆動部にて前記作動ケーブルの遠位端に固定されたアジャスターを備え、
前記作動ケーブルは、前記アクチュエータから前記ルーメン、前記近位関節駆動部、前記遠位関節駆動部を通って延び、前記アクチュエータまで戻る単一のケーブルであって、近位部ナックル、ルーメンナックル及び前記近位プーリアッセンブリで曲げられ、前記近位関節駆動部で前記ルーメンに対して相対的に回動するように設定された作動部と、前記近位関節駆動部及び前記ルーメンに対して略平行で、該ルーメンと略平行な前記近位関節駆動部まで戻されるリターン部とを備え、
前記アジャスターは、前記遠位関節駆動部の遠位端に対する前記作動ケーブルの動きを防止することを特徴とする関節駆動式手術器具。 - 請求項7記載の関節駆動式手術器具において、
前記アジャスターはさらに、前記遠位ヒンジピンと略平行な方向に延び、前記作動ケーブルの遠位端を前記遠位関節駆動部で曲げるロッキングバーと、
前記遠位関節駆動部に位置し、前記作動ケーブルを前記ロッキングバーに調整自在に当接させることで該作動ケーブルの動きを調節自在に防止するカムバーと、を備えていることを特徴とする関節駆動式手術器具。 - 請求項8記載の関節駆動式手術器具において、
前記ロッキングバーの外周には、前記作動ケーブルを通して曲げる螺旋状の溝が設けられていることを特徴とする関節駆動式手術器具。 - 請求項7記載の関節駆動式手術器具において、
前記作動ケーブルの作動部とリターン部が前記ルーメンの長手方向軸に対して径方向に傾斜していることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記遠位関節駆動部の最も遠位端には、適合する医療ツールを着脱自在としたことを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位プーリアッセンブリは、前記近位ヒンジピンを中心に同軸回転可能な第1近位プーリ及び第2近位プーリを備えていて、
前記作動ケーブルは、前記第1近位プーリに巻かれた作動部と、前記第2近位プーリに巻かれたリターン部とを備え、
前記作動ケーブルが作動している間は、前記作動部が動かされて前記第1近位プーリを前記近位ヒンジピンを中心にして回転させ、前記リターン部が動かされて前記第2近位プーリを前記近位ヒンジピンを中心にして前記第1近位プーリの回転方向とは反対側方向に回転させることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位プーリアッセンブリは、前記近位ヒンジピンを中心に同軸回転可能な第1近位プーリと第2近位プーリを備え、
前記遠位プーリアッセンブリは、前記遠位ヒンジピンを中心に同軸回転可能な第1遠位プーリと第2遠位プーリを備え、
前記作動ケーブルは、
前記第1近位プーリ及び前記第1遠位プーリに巻かれた作動部と、
前記第2近位プーリ及び前記第2遠位プーリに巻かれたリターン部とを備え、
前記作動ケーブルの作動中、作動部が動かされて前記第1近位プーリ及び前記第1遠位プーリが前記近位ヒンジピン及び前記遠位ヒンジピンを中心にして個々に回転し、前記リターン部が動かされて前記第2近位プーリ及び前記第2遠位プーリが前記近位ヒンジピン及び前記遠位ヒンジピンを中心にして、前記第1近位プーリ及び前記第1遠位プーリの回転方向とは反対方向で個々に回転することを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記作動ケーブルは、ステンレス鋼撚線からなることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位関節駆動部は、前記近位ヒンジピンを中心としての移動量が前記ルーメンの長手方向軸に対して0°から90°までの範囲に制限されていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記近位関節駆動部は、前記近位ヒンジピンを中心としての移動量が前記ルーメンの長手方向軸に対して0°から90°までの範囲に制限されていること、及び、
前記遠位関節駆動部は、該遠位関節駆動部の移動量が前記ルーメンの長手方向軸に対して0°から180°の範囲に制限されるように、前記遠位ヒンジピンを中心としての移動量が前記近位関節駆動部の長手方向軸に対して0°から90°までの範囲に制限されていること、を特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記ハンドピースは、前記アクチュエータをロックし、このアクチュエータのロックに応じて、前記近位関節駆動部の回動をロックする関節駆動ロック手段を備えていることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記ハンドピースは、
ノーズピース及びハンドルと、
このノーズピース及びハンドルのいずれか一つの上に配置され、ノーズピースに対して相対的なハンドルの回転可能位置をロック可能にするハンドル回転解除手段と、を備えたことを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記作動ケーブルは約0.027インチの外径を有していることを特徴とする関節駆動式手術器具。 - 請求項1記載の関節駆動式手術器具において、
前記ルーメンの外径は約5mmであることを特徴とする関節駆動式手術器具。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US12/850,905 US8900267B2 (en) | 2010-08-05 | 2010-08-05 | Articulable surgical instrument |
US12/850,905 | 2010-08-05 |
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JP2011147839A Division JP5383751B2 (ja) | 2010-08-05 | 2011-07-04 | 関節駆動式手術器具 |
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JP2013123516A Active JP5902645B2 (ja) | 2010-08-05 | 2013-06-12 | 関節駆動式手術器具及びその操作方法 |
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US (2) | US8900267B2 (ja) |
EP (2) | EP2415409A1 (ja) |
JP (2) | JP5383751B2 (ja) |
CA (1) | CA2745184C (ja) |
ES (1) | ES2564660T3 (ja) |
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US11896225B2 (en) | 2004-07-28 | 2024-02-13 | Cilag Gmbh International | Staple cartridge comprising a pan |
US8215531B2 (en) | 2004-07-28 | 2012-07-10 | Ethicon Endo-Surgery, Inc. | Surgical stapling instrument having a medical substance dispenser |
US7934630B2 (en) | 2005-08-31 | 2011-05-03 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
US11484312B2 (en) | 2005-08-31 | 2022-11-01 | Cilag Gmbh International | Staple cartridge comprising a staple driver arrangement |
US7669746B2 (en) | 2005-08-31 | 2010-03-02 | Ethicon Endo-Surgery, Inc. | Staple cartridges for forming staples having differing formed staple heights |
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JP2013215594A (ja) | 2013-10-24 |
CA2745184C (en) | 2014-01-21 |
US9642603B2 (en) | 2017-05-09 |
CA2745184A1 (en) | 2012-02-05 |
JP5383751B2 (ja) | 2014-01-08 |
US20120035617A1 (en) | 2012-02-09 |
JP2012035065A (ja) | 2012-02-23 |
EP2415403A1 (en) | 2012-02-08 |
EP2415409A1 (en) | 2012-02-08 |
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