JP5908412B2 - 回転可能なブレード及び中空のシース構成を有する超音波外科用器具 - Google Patents
回転可能なブレード及び中空のシース構成を有する超音波外科用器具 Download PDFInfo
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- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
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- A61B17/32—Surgical cutting instruments
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- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
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- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
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- 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
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
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Description
米国特許出願番号第_____、表題「ULTRASONICALLY POWERED SURGICAL INSTRUMENTS WITH ROTATING CUTTING IMPLEMENT」、代理人整理番号第END6688USNP/090341号、
米国特許出願番号第_____号、表題「METHODS OF USING ULTRASONICALLY POWERED SURGICAL INSTRUMENTS WITH ROTATABLE CUTTING IMPLEMENTS」、代理人整理番号第END6689USNP/090342号、
同第_____号、表題「SEAL ARRANGEMENTS FOR ULTRASONICALLY POWERED SURGICAL INSTRUMENTS」、代理人整理番号第END6690USNP/090343号、
同第_____号、表題「ROTATABLE CUTTING IMPLEMENT ARRANGEMENTS FOR ULTRASONIC SURGICAL INSTRUMENTS」、代理人整理番号第END6692USNP/090345号、
同第_____号、表題「ULTRASONIC SURGICAL INSTRUMENTS WITH PARTIALLY ROTATING BLADE AND FIXED PAD ARRANGEMENT」、代理人整理番号第END6693USNP/090346号、
同第_____号、表題「DUAL PURPOSE SURGICAL INSTRUMENT FOR CUTTING AND COAGULATING TISSUE」、代理人整理番号第END6694USNP/090347号、
同第_____号、表題「OUTER SHEATH AND BLADE ARRANGEMENTS FOR ULTRASONIC SURGICAL INSTRUMENTS」、代理人整理番号第END6695USNP/090348号、
同第_____号、表題「ULTRASONIC SURGICAL INSTRUMENTS WITH MOVING CUTTING IMPLEMENT」、代理人整理番号第END6687USNP/090349号、及び
同第_____号、表題「ULTRASONIC SURGICAL INSTRUMENT WITH COMB−LIKE TISSUE TRIMMING DEVICE」、代理人整理番号第END6686USNP/090367号。
図1は、外科用システム10の非限定的な実施形態を、概略的な形態で例示する。外科用システム10は、超音波発生器12、及び「内蔵型」超音波器具110を含み得る、超音波外科用器具アセンブリ100を含み得る。以下でより詳細に記載されるように、超音波発生器12は、ケーブル14によって内蔵型超音波器具110の超音波変換器アセンブリ114へと、外科用器具アセンブリ100のハウジング部分102内に位置するスリップリングアセンブリ150により接続され得る。一実施形態において、システム10は、モータ制御システム20を更に含み、これは電源22を含み、これはケーブル23によって制御モジュール24に連結されて、ここに例えば24VDCを供給する。モータ制御モジュール24は、National Instruments(Austin,Texas)により、モデル番号NI cRIO−9073で製造される制御モジュールを含み得る。しかしながら、他のモータ制御モジュールも利用され得る。電源22は、National Instrumentsによって製造される電源を含み得る。しかしながら、他の電源も良好に利用され得る。電源22はケーブル25によってモータ駆動26に更に連結され、やはりモータ駆動26に24DVCを供給し得る。モータ駆動26はNational Instrumentsによって製造されるモータ駆動を含み得る。制御モジュール24はまた、モータ駆動26に電力を供給するために、ケーブル27によりモータ駆動26に連結され得る。従来的なフットペダル30又は他の制御スイッチ構成が、ケーブル31によって制御モジュール24に取り付けられてもよい。以下でより詳細に記載されるように、超音波外科用器具100は、関連するエンコーダ194を有するモータ190を含み得る。モータ190は、National Instrumentsによりモデル番号CTP12ELF10MAA00として製造されるモータを含み得る。エンコーダ194は、U.S.Digital(Vancouver,Washington)によりモデル番号第E2−500−197−I−D−D−Bとして製造されるエンコーダを含み得る。しかしながら、他のモータ及びエンコーダも使用され得る。エンコーダ194は、エンコーダケーブル32によってモータ制御モジュール24に連結されてもよく、モータ190はケーブル33によってモータ駆動26に連結され得る。外科用システム10は、イーサネットケーブル42によってモータ制御モジュール24と通信し得る、コンピューター40を含み得る。
図2に見られるように、超音波外科用器具ハンドピース100は、モータ190、エンコーダ194、スリップリングアセンブリ150、及び内蔵型超音波外科用器具110を収容するハウジング102を含み得る。ハウジング102は、ねじ、スナップ機構などの締結具によって一緒に取り付けられる2つ以上の部分で提供されてもよく、例えば、ポリカーボネート材料から作製されてもよい。モータ190は、例えばNational Instrumentsにより、モデル番号CTP12ELF10MAA00として製造される、ステッピングモータを含み得る。しかしながら、例えばハウジング102に対する内蔵型超音波外科用器具110の、約1〜6000rpmの「全」回転運動を生じるために他のモータが利用され得る。エンコーダ194は、モータシャフト192の機械的回転を速度及び他のモータ制御情報を制御モジュール24に提供する電気パルスに変換する。
現在の関節鏡視下ツールは、パンチ、往復式シェーバー、及び無線周波(RF)駆動装置を含む。パンチ及びシェーバーなどの機械的装置は、最小限の組織損傷を生じる傾向にあるが、場合によっては望ましくない、粗い切断線を残す場合がある。RF駆動ブレードは、より滑らかな切断線を残し、また、大面積の軟組織を焼灼し得る。しかしながら、このような装置は、純粋な機械的器具よりも大きな組織損傷を生じ得る。上記の様々な非限定的な外科用器具の実施形態は、従来的なRF駆動外科用器具、加えて回転組織切断部材を利用する従来的な機械的シェーバーよりも、有利なホストを提供する。以下でより詳細に記載されるように、様々な非限定的な実施形態の固有かつ新規のブレード及びシース構成を利用することにより、追加的な利益が実現され得る。
(1) 超音波外科用器具であって、
ハウジングと、
前記ハウジング内に回転可能に支持され、超音波電気信号源と通信する超音波変換器アセンブリと、
前記ハウジング内にあり、モータ駆動信号源と通信するモータであって、前記モータは、前記超音波変換器アセンブリに回転運動を適用するために前記超音波変換器アセンブリと通信する、モータと、
前記超音波変換器アセンブリに連結されるホーンと、
前記ハウジングに連結され、内部に少なくとも1つのアクセスウィンドーを有する中空のシースと、
前記少なくとも1つのアクセスウィンドーに組織を引き込むために、前記中空のシースと通信する真空源と、
前記ホーンに連結され、前記中空のシース内で延びるブレードであって、前記ブレードは、前記少なくとも1つのアクセスウィンドーを通じて引きこまれた組織と相互作用するように構成された、少なくとも1つの遠位組織切断部を上部に有する、ブレードとを含む、超音波外科用器具。
(2) 前記中空のシースが、閉じた、実質的に鈍い遠位端部を有する、実施態様1に記載の超音波外科用器具。
(3) 前記中空のシースが丸い遠位端を有し、前記ブレードは、前記中空のシースの前記丸い遠位端におけるブレードアクセス開口部を通じて外に突出する、実質的に鈍い遠位先端部を有する、実施態様1に記載の超音波外科用器具。
(4) 前記少なくとも1つのアクセスウィンドーは、前記中空のシースの前記遠位端の前記ブレードアクセス開口部から横方向に延びる2つの横方向ウィンドー部分を含む、実施態様3に記載の超音波外科用器具。
(5) 前記少なくとも1つのアクセスウィンドーの少なくとも1つが、そこに形成された、少なくとも1つの鋭い縁部を有する、実施態様1に記載の超音波外科用器具。
(6) 前記少なくとも1つのアクセスウィンドーの少なくとも1つが、2つの対向する、内側に延びる切断縁部を有する、実施態様1に記載の超音波外科用器具。
(7) 前記中空のシースが、前記少なくとも1つのアクセスウィンドーの少なくとも1つに隣接して、内部に取り付けられた、少なくとも2つの切断挿入部を有する、実施態様1に記載の超音波外科用器具。
(8) 前記ブレードが、内部に形成された一対の対向する弓状チャネルを有する、実施態様1に記載の超音波外科用器具。
(9) 前記ブレードが湾曲した遠位先端部を有する、実施態様1に記載の超音波外科用器具。
(10) 前記湾曲した遠位先端部はそこに、鋭い、横方向の縁部を有する、実施態様9に記載の超音波外科用器具。
(12) 前記少なくとも1つのアクセスウィンドーが剪断縁部を形成し、前記超音波外科用器具が、前記剪断縁部に取り付けられた摩擦低減パッドを更に含む、実施態様1に記載の超音波外科用器具。
(13) 前記ブレードが上部に非平坦化した表面を有する、実施態様1に記載の超音波外科用器具。
(14) 前記ブレードが上面を有し、少なくとも1つの切断歯がそこから半径方向に突出する、実施態様1に記載の超音波外科用器具。
(15) 前記少なくとも1つの遠位先端切断部は、その少なくとも1つの横方向縁部上に形成された鋸歯状の歯を含む、実施態様1に記載の超音波外科用器具。
(16) 前記中空のシースにおける前記アクセスウィンドーが、第1横方向切断縁部及び第2横方向切断縁部を有する切断縁部を形成する、実施態様15に記載の超音波外科用器具。
(17) 前記ブレードの前記遠位先端部が前記中空のシースに対して第1回転位置にあるときに、前記第1横方向切断縁部と前記ブレードの前記遠位先端部との間に第1横方向吸引経路を全体的に形成し、前記ブレードの前記遠位先端部が前記中空のシースに対して第2回転位置にあるときに、前記第2横方向切断縁部と前記ブレードの前記遠位先端部との間に第2横方向吸引経路を全体的に形成する、各前記鋸歯状の歯の間の開口部を更に含む、実施態様16に記載の超音波外科用器具。
(18) 前記ブレードの前記遠位先端部が、前記中空のシースに対して第3回転位置にあるときに、前記遠位先端部が、前記ブレードの前記遠位先端部と前記中空のシースとの間に第3吸引経路を形成する、実施態様17に記載の超音波外科用器具。
(19) 超音波外科用器具であって、
ハウジングと、
前記ハウジング内に支持され、超音波電気信号源と通信する超音波変換器アセンブリと、
前記超音波変換器アセンブリに連結されるホーンと、
前記ホーンから超音波運動を受け取るために、前記ホーンに連結される、前記ハウジングから突出する中空のシースと、
前記ハウジング内にあり、モータ駆動信号源と通信するモータと、
前記モータに連結され、前記中空のシース内部で回転移動するように前記中空のシース内に延びるブレードであって、前記ブレードは、前記中空のシースの遠位部分を通じて露出される遠位組織切断部分を有する、ブレードとを含む、超音波外科用器具。
(20) 前記中空のシースは、上部に形成された、実質的に鈍い端部と、前記ブレードの前記遠位切断部を露出するため、前記実質的に鈍い端部に隣接して、内部に形成された少なくとも1つのウィンドーとを有する、実施態様19に記載の超音波外科用器具。
前記吸引空洞と連通する吸引源と、
内部での排出のために、前記吸引空洞を通じて延びる、前記中空のシースの前記一部内の少なくとも1つの近位シース開口部であって、前記ブレードの一部が中空であり、前記少なくとも1つの近位シース開口部の少なくとも1つと対応する少なくとも1つのブレード排出ポートを有する、少なくとも1つの近位シース開口部と、
前記中空のシース内に前記ブレードを回転可能に支持し、前記ブレードと前記吸引空洞を通じて延びる前記中空のシースの前記一部との間に実質的に流体密の封止を形成する、ブレード封止部とを更に含む、実施態様20に記載の超音波外科用器具。
(22) 前記ブレードの前記露出した遠位切断部は、前記中空のシース内の前記少なくとも1つのウィンドーと対応する、切断開口部を内部に含む、実施態様20に記載の超音波外科用器具。
(23) 前記ブレードの前記露出した遠位切断部は、前記ブレードの遠位端上に少なくとも1つの鋸歯状の切断歯を含む、実施態様19に記載の超音波外科用器具。
(24) 前記外部シースに可動に軸支された安全シースであって、前記安全シースが前記ウィンドーを被覆する閉鎖位置と、前記ウィンドーの少なくとも一部が露出している開放位置との間で選択的に可動である、安全シースを更に含む、実施態様20の超音波外科用器具。
(25) 前記安全シースを、前記開放位置の少なくとも1つに、解放可能に維持するために、前記外部シースに少なくとも1つの保持器を更に含む、実施態様24に記載の超音波外科用器具。
(26) 前記安全シースへの作動運動の適用を促進するために、前記安全シース上に作動部材を更に含む、実施態様25に記載の超音波外科用器具。
Claims (26)
- 超音波外科用器具であって、
ハウジングと、
前記ハウジング内に回転可能に支持され、超音波電気信号源と通信する超音波変換器アセンブリと、
前記ハウジング内にあり、モータ駆動信号源と通信するモータであって、前記モータは、前記超音波変換器アセンブリに回転運動を適用するために前記超音波変換器アセンブリと連絡する、モータと、
前記超音波変換器アセンブリに連結されるホーンと、
前記ハウジングに連結され、内部に少なくとも1つのアクセスウィンドーを有する中空のシースであって、当該中空シースは吸引ポートを有する、中空シースと、
前記中空シースに少なくとも部分的に囲まれる内部シースであって、当該内部シースと前記中空シースとはそれらの間に吸引経路を形成するように構成され、当該吸引経路は前記吸引ポートを通って延びる、内部シースと、
前記少なくとも1つのアクセスウィンドーに組織を引き込むために、前記吸引経路と連絡する真空源と、
前記ホーンに連結され、前記内部シース内で少なくとも一部が延びるブレードであって、前記ブレードは、前記少なくとも1つのアクセスウィンドーを通じて引きこまれた組織と相互作用するように構成された、少なくとも1つの遠位組織切断部を有する、ブレードと、を含み、
前記内部シースは、前記吸引経路と前記ブレードとの間を延び、前記ブレードを前記吸引経路から分離する、超音波外科用器具。 - 前記中空のシースが、閉じた、実質的に鈍い遠位端部を有する、請求項1に記載の超音波外科用器具。
- 前記中空のシースが丸い遠位端を有し、前記ブレードは、前記中空のシースの前記丸い遠位端におけるブレードアクセス開口部を通じて外に突出する、実質的に鈍い遠位先端部を有する、請求項1に記載の超音波外科用器具。
- 前記少なくとも1つのアクセスウィンドーは、前記中空のシースの前記遠位端の前記ブレードアクセス開口部から横方向に延びる2つの横方向ウィンドー部分を含む、請求項3に記載の超音波外科用器具。
- 前記少なくとも1つのアクセスウィンドーの少なくとも1つが、そこに形成された、少なくとも1つの鋭い縁部を有する、請求項1に記載の超音波外科用器具。
- 前記少なくとも1つのアクセスウィンドーの少なくとも1つが、2つの対向する、内側に延びる切断縁部を有する、請求項1に記載の超音波外科用器具。
- 前記中空のシースが、前記少なくとも1つのアクセスウィンドーの少なくとも1つに隣接して、内部に取り付けられた、少なくとも2つの切断挿入部を有する、請求項1に記載の超音波外科用器具。
- 前記ブレードが、内部に形成された一対の対向する弓状チャネルを有する、請求項1に記載の超音波外科用器具。
- 前記ブレードが湾曲した遠位先端部を有する、請求項1に記載の超音波外科用器具。
- 前記湾曲した遠位先端部はそこに、鋭い、横方向の縁部を有する、請求項9に記載の超音波外科用器具。
- 前記少なくとも1つの遠位組織切断部は、V字型、半円形、及び平坦な底部のC字型からなる断面形状群から選択される、断面形状を有する、内部に形成された陥没領域を有する、前記ブレードの一部に形成される、請求項1に記載の超音波外科用器具。
- 前記少なくとも1つのアクセスウィンドーが剪断縁部を形成し、前記超音波外科用器具が、前記剪断縁部に取り付けられた摩擦低減パッドを更に含む、請求項1に記載の超音波外科用器具。
- 前記ブレードが上部に非平坦化した表面を有する、請求項1に記載の超音波外科用器具。
- 前記ブレードが上面を有し、少なくとも1つの切断歯がそこから半径方向に突出する、請求項1に記載の超音波外科用器具。
- 前記少なくとも1つの遠位先端切断部は、その少なくとも1つの横方向縁部上に形成された鋸歯状の歯を含む、請求項1に記載の超音波外科用器具。
- 前記中空のシースにおける前記アクセスウィンドーが、第1横方向切断縁部及び第2横方向切断縁部を有する切断縁部を形成する、請求項15に記載の超音波外科用器具。
- 前記ブレードの前記遠位先端部が前記中空のシースに対して第1回転位置にあるときに、前記第1横方向切断縁部と前記ブレードの前記遠位先端部との間に第1横方向吸引経路を全体的に形成し、前記ブレードの前記遠位先端部が前記中空のシースに対して第2回転位置にあるときに、前記第2横方向切断縁部と前記ブレードの前記遠位先端部との間に第2横方向吸引経路を全体的に形成する、各前記鋸歯状の歯の間の開口部を更に含む、請求項16に記載の超音波外科用器具。
- 前記ブレードの前記遠位先端部が、前記中空のシースに対して第3回転位置にあるときに、前記遠位先端部が、前記ブレードの前記遠位先端部と前記中空のシースとの間に第3吸引経路を形成する、請求項17に記載の超音波外科用器具。
- 超音波外科用器具であって、
ハウジングと、
前記ハウジング内に支持され、超音波電気信号源と通信する超音波変換器アセンブリと、
前記超音波変換器アセンブリに連結されるホーンと、
前記ホーンから超音波運動を受け取るために、前記ホーンに連結される、前記ハウジングから突出する中空のシースと、
前記ハウジング内にあり、モータ駆動信号源と通信するモータと、
前記モータに連結され、前記中空のシース内部で回転移動するように前記中空のシース内に延びるブレードであって、前記ブレードは、前記中空のシースの遠位部分を通じて露出される遠位組織切断部分を有する、ブレードと、を含む、超音波外科用器具。 - 前記中空のシースは、上部に形成された、実質的に鈍い端部と、前記ブレードの前記遠位切断部を露出するため、前記実質的に鈍い端部に隣接して、内部に形成された少なくとも1つのウィンドーとを有する、請求項19に記載の超音波外科用器具。
- 前記中空のシースの一部が内部を通じて延びるような、前記ハウジング内の吸引空洞と、
前記吸引空洞と連通する吸引源と、
内部での排出のために、前記吸引空洞を通じて延びる、前記中空のシースの前記一部内の少なくとも1つの近位シース開口部であって、前記ブレードの一部が中空であり、前記少なくとも1つの近位シース開口部の少なくとも1つと対応する少なくとも1つのブレード排出ポートを有する、少なくとも1つの近位シース開口部と、
前記中空のシース内に前記ブレードを回転可能に支持し、前記ブレードと前記吸引空洞を通じて延びる前記中空のシースの前記一部との間に実質的に流体密の封止を形成する、ブレード封止部とを更に含む、請求項20に記載の超音波外科用器具。 - 前記ブレードの前記露出した遠位切断部は、前記中空のシース内の前記少なくとも1つのウィンドーと対応する、切断開口部を内部に含む、請求項20に記載の超音波外科用器具。
- 前記ブレードの前記露出した遠位切断部は、前記ブレードの遠位端上に少なくとも1つの鋸歯状の切断歯を含む、請求項19に記載の超音波外科用器具。
- 前記外部シースに可動に軸支された安全シースであって、前記安全シースが前記ウィンドーを被覆する閉鎖位置と、前記ウィンドーの少なくとも一部が露出している開放位置との間で選択的に可動である、安全シースを更に含む、請求項20の超音波外科用器具。
- 前記安全シースを、前記開放位置の少なくとも1つに、解放可能に維持するために、前記外部シースに少なくとも1つの保持器を更に含む、請求項24に記載の超音波外科用器具。
- 前記安全シースへの作動運動の適用を促進するために、前記安全シース上に作動部材を更に含む、請求項25に記載の超音波外科用器具。
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AU2011215911A1 (en) | 2012-08-23 |
EP2533704A1 (en) | 2012-12-19 |
CN102843979A (zh) | 2012-12-26 |
WO2011100323A1 (en) | 2011-08-18 |
EP2533704B1 (en) | 2019-10-02 |
US20110196399A1 (en) | 2011-08-11 |
CA2789012A1 (en) | 2011-08-18 |
JP2013519437A (ja) | 2013-05-30 |
BR112012020120A2 (pt) | 2018-08-07 |
BR112012020120B1 (pt) | 2020-06-02 |
US9259234B2 (en) | 2016-02-16 |
AU2011215911B2 (en) | 2015-09-10 |
CN102843979B (zh) | 2015-12-02 |
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