JP5925281B2 - 外科用鉗子 - Google Patents
外科用鉗子 Download PDFInfo
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- JP5925281B2 JP5925281B2 JP2014227674A JP2014227674A JP5925281B2 JP 5925281 B2 JP5925281 B2 JP 5925281B2 JP 2014227674 A JP2014227674 A JP 2014227674A JP 2014227674 A JP2014227674 A JP 2014227674A JP 5925281 B2 JP5925281 B2 JP 5925281B2
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- 230000004913 activation Effects 0.000 claims description 28
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Description
本開示は、外科用器具に関し、より詳細には、延びることのできる単極要素を含む双極外科用鉗子に関する。
双極電気外科用鉗子は、通常、組織に選択的にエネルギーを印加するために、異なる電位に荷電されている2つの概ね対向する電極を含む。双極電気外科用鉗子は、機械的締め付け作用と組織および血管を加熱することにより止血をもたらす電気エネルギーの両方を利用し、組織を凝固させ、かつ/または焼灼する。特定の外科処置は、単に組織を焼灼することよりも多くを必要とし、組織、血管、および特定の脈管束を「密閉」するために、締め付け圧力、正確な電気外科エネルギーの制御、および間隙距離(すなわち、組織の周りに閉じられたときの対向する顎部材間の距離)の独特な組み合わせに依存する。通常、血管が密閉されると、外科医は、新しく形成された組織シールに沿って血管を正確に切断しなければならない。従って、組織シールを形成した後に組織を効果的に切断するナイフまたはブレード部材を組み込む多くの鉗子が設計されている。
(項目1)
鉗子であって、該鉗子は、
第1の顎部材と第2の顎部材とを含むエンドエフェクタアセンブリであって、該顎部材のうちの少なくとも一方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能であり、該顎部材のうちの少なくとも一方は、組織を治療するために、該顎部材間で、および該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成されている、エンドエフェクタアセンブリと、
絶縁性管状部材であって、該絶縁性管状部材は、該絶縁性管状部材が該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリの周りに配置される延ばされた位置との間で該エンドエフェクタアセンブリに対して移動可能である、絶縁性管状部材と、
単極部材であって、該単極部材は、該絶縁性管状部材が該延ばされた位置に配置されている場合、組織を治療するために、組織にエネルギーを印加するように構成されている、単極部材と
を備えている、鉗子。
(項目2)
上記単極部材は内側管状部材を含み、該内側管状部材は、上記絶縁性管状部材内に配置され、かつ該絶縁性管状部材と係合させられ、該内側管状部材の一部分は、該絶縁性管状部材から遠位方向に延び、それによって、該絶縁性管状部材の該延ばされた位置において、該内側管状部材の一部分は、該エンドエフェクタアセンブリから遠位方向に延び、組織を治療するために、組織にエネルギーを印加する、上記項目のいずれか一項に記載の鉗子。
(項目3)
上記絶縁性管状部材から遠位方向に延びている上記内側管状部材の一部分は、組織の機械的切開を容易にするようにさらに構成されている、上記項目のいずれか一項に記載の鉗子。
(項目4)
上記絶縁性管状部材から遠位方向に延びている上記内側管状部材の一部分は、勾配付き遠位端、環状の遠位端、該内側管状部材の一部分から遠位方向に延びているブレード、および該内側管状部材の一部分から遠位方向に延びているフックのうちの1つを含む、上記項目のいずれか一項に記載の鉗子。
(項目5)
上記内側管状部材は、解放可能に係合可能な遠位先端を含み、該解放可能に係合可能な遠位先端は、上記絶縁性管状部材から遠位方向に延びている、上記項目のいずれか一項に記載の鉗子。
(項目6)
上記解放可能に係合可能な遠位先端は、勾配付き遠位端を含む第1の遠位先端、第2の遠位先端であって、該第2の遠位先端は、該第2の遠位先端から遠位方向に延びているブレードを含む、第2の遠位先端、第3の遠位先端であって、該第3の遠位先端は、該第3の遠位先端から遠位方向に延びているフックを含む、第3の遠位先端、および環状の遠位端を含む第4の遠位先端のうちの少なくとも1つを含む複数の遠位先端から選択される、上記項目のいずれか一項に記載の鉗子。
(項目7)
シャフトをさらに備え、該シャフトは、該シャフトの遠位端において上記エンドエフェクタアセンブリに結合され、上記絶縁性管状部材は、該シャフトの周りに配置され、かつ、上記引き込まれた位置と延ばされた位置との間で該シャフトに対してスライド可能である、上記項目のいずれか一項に記載の鉗子。
(項目8)
スライドノブを含むスライドアセンブリをさらに備え、該スライドノブは、上記絶縁性管状部材に結合され、かつ、上記引き込まれた位置と延ばされた位置との間で該絶縁性管状部材を移動させるための第1の位置と第2の位置との間で選択的に移動可能である、上記項目のいずれか一項に記載の鉗子。
(項目9)
上記少なくとも一方の顎部材に選択的にエネルギーを供給するための第1の起動スイッチと、上記単極部材に選択的にエネルギーを供給するための第2の起動スイッチとをさらに備えている、上記項目のいずれか一項に記載の鉗子。
(項目10)
上記第1の起動スイッチおよび上記第2の起動スイッチのうちの少なくとも一方は、それぞれ、上記絶縁性管状部材が、上記延ばされた位置および上記引き込まれた位置に配置された場合、起動することから阻止される、上記項目のいずれか一項に記載の鉗子。
(項目11)
上記顎部材のうちの少なくとも一方は遠位先端部分を含み、該少なくとも一方の顎部材の該遠位先端部分は、上記絶縁性管状部材が延ばされた位置に配置された場合に組織を治療するために組織にエネルギーを印加するための単極部材を画定する、上記項目のいずれか一項に記載の鉗子。
(項目12)
上記少なくとも一方の顎部材の上記遠位先端部分は、組織の機械的切開を容易にするようにさらに構成されている、上記項目のいずれか一項に記載の鉗子。
(項目13)
上記絶縁性管状部材は、該絶縁性管状部材に画定されている切り欠きを含み、上記少なくとも一方の顎部材の上記遠位先端部分は、該絶縁性管状部材が延ばされた位置に配置された場合、該切り欠きを貫通するように構成されている、上記項目のいずれか一項に記載の鉗子。
(項目14)
鉗子であって、該鉗子は、
第1の顎部材と第2の顎部材とを含むエンドエフェクタアセンブリであって、該顎部材のうちの少なくとも一方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能であり、該顎部材のうちの少なくとも一方は、組織を治療するために、該顎部材間で、および該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成されている、エンドエフェクタアセンブリと、
単極アセンブリであって、該単極アセンブリは、絶縁性管状部材と、組織を治療するために、組織にエネルギーを印加するように構成されている導電性遠位部材とを含み、該導電性遠位部材は、該絶縁性管状部材と係合させられ、かつ、該絶縁性管状部材から遠位方向に延び、該単極アセンブリは、該単極アセンブリが該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリを実質的に取り囲み、該導電性遠位部材が該エンドエフェクタアセンブリから遠位方向に延びる延ばされた位置との間で該エンドエフェクタアセンブリに対して移動可能である、単極アセンブリと
を備えている、鉗子。
(項目15)
上記導電性遠位部材は、解放可能に係合可能な遠位先端を含み、該解放可能に係合可能な遠位先端は、上記絶縁性管状部材から遠位方向に延びている、上記項目のいずれか一項に記載の鉗子。
(項目16)
上記解放可能に係合可能な遠位先端は、勾配付き遠位端を含む第1の遠位先端、第2の遠位先端であって、該第2の遠位先端は、該第2の遠位先端から遠位方向に延びているブレードを含む、第2の遠位先端、第3の遠位先端であって、該第3の遠位先端は、該第3の遠位先端から遠位方向に延びているフックを含む、第3の遠位先端、および環状の遠位端を含む第4の遠位先端のうちの少なくとも1つを含む複数の遠位先端から選択される、上記項目のいずれか一項に記載の鉗子。
(項目17)
スライドノブを含むスライドアセンブリをさらに備え、該スライドノブは、上記単極アセンブリに結合され、かつ、上記引き込まれた位置と延ばされた位置との間で該単極アセンブリを移動させるための第1の位置と第2の位置との間で選択的に移動可能である、上記項目のいずれか一項に記載の鉗子。
鉗子は、第1の顎部材と第2の顎部材とを含むエンドエフェクタアセンブリを含む。該顎部材のうちの一方または両方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能である。該顎部材のうちの一方または両方は、組織を治療するために、該顎部材間で、および該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成されている。絶縁性管状部材は、該絶縁性管状部材が該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリの周りに配置される延ばされた位置との間で該エンドエフェクタアセンブリに対して移動可能である。単極部材は、該絶縁性管状部材が該延ばされた位置に配置されている場合、組織を治療するために、組織にエネルギーを印加するように構成されている。
ここで、図1〜図3を参照すると、双極モード(例えば、組織を把持、治療、および/または切開するための)と単極モード(例えば、組織を治療および/または切開するための)の両方で動作するための特徴を含む鉗子は、概して、参照番号10によって識別されるとして示されている。鉗子10は、内視鏡的鉗子10として示されているが、しかし、鉗子10は、従来のオープン外科処置との関連でも使用されるように構成されることが勘案されている。明らかに、特定の構成ごとに異なる電気的および機械的接続ならびに考慮事項が適用されるが、しかし、鉗子10およびその動作的特徴に関する新規な局面は、オープン構成と内視鏡的構成の両方に対して概ね整合性を保つ。
10 鉗子
12 シャフト
14 遠位端
16 近位端
20 筐体
30 ハンドルアセンブリ
40 移動可能ハンドル
50 固定ハンドル
80 トリガアセンブリ
82 トリガ
90 第1の起動スイッチ
95 第2の起動スイッチ
100 エンドエフェクタアセンブリ
110 顎部材
120 顎部材
200 単極アセンブリ
210 電気絶縁性外側管状部材
220 導電性内側管状部材
Claims (9)
- 鉗子であって、該鉗子は、
筐体と、
該筐体から遠位に延びているシャフトと、
該シャフトの遠位端に配置されたエンドエフェクタアセンブリであって、該エンドエフェクタアセンブリは、第1の顎部材および第2の顎部材を含み、該顎部材のうちの少なくとも一方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能であり、該第1の顎部材および該第2の顎部材は、双極のエネルギーを用いて組織を治療するために、該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成されている、エンドエフェクタアセンブリと、
該シャフトの周りに配置された絶縁性管状部材であって、該絶縁性管状部材は、該シャフトの周りでスライド可能であり、該絶縁性管状部材は、該絶縁性管状部材が該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリの該第1の顎部材および該第2の顎部材の周りに配置される延ばされた位置との間で該エンドエフェクタアセンブリに対してスライド可能である、絶縁性管状部材と、
該絶縁性管状部材に結合された単極部材であって、該単極部材は、該絶縁性管状部材が該延ばされた位置に配置されている場合、単極のエネルギーを用いて組織を治療するために、組織にエネルギーを印加するように構成されており、該延ばされた位置において、該絶縁性管状部材は、該単極部材から該第1の顎部材および該第2の顎部材を絶縁することを容易にする、単極部材と、
該筐体上に配置され、かつ、該絶縁性管状部材に結合された作動ノブであって、該作動ノブは、該引き込まれた位置と該延ばされた位置との間で該絶縁性管状部材を移動させるために第1の位置と第2の位置との間で選択的に移動可能である、作動ノブと
を備えている、鉗子。 - 前記少なくとも一方の顎部材に選択的にエネルギーを供給するための第1の起動スイッチと、前記単極部材に選択的にエネルギーを供給するための第2の起動スイッチとをさらに備えている、請求項1に記載の鉗子。
- 前記第1の起動スイッチおよび前記第2の起動スイッチのうちの少なくとも一方は、それぞれ、前記絶縁性管状部材が前記延ばされた位置および前記引き込まれた位置に配置された場合、起動されることが阻止される、請求項2に記載の鉗子。
- 鉗子であって、該鉗子は、
筐体と、
該筐体から遠位に延びているシャフトと、
該シャフトの遠位端に配置されたエンドエフェクタアセンブリであって、該エンドエフェクタアセンブリは、第1の顎部材および第2の顎部材を含み、該顎部材のうちの少なくとも一方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能であり、該第1の顎部材および該第2の顎部材は、双極のエネルギーを用いて組織を治療するために、該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成された主要部分を含む、エンドエフェクタアセンブリと、
該シャフトの周りに配置された絶縁性管状部材であって、該絶縁性管状部材は、該シャフトの周りでスライド可能であり、該絶縁性管状部材は、該絶縁性管状部材が該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリの該第1の顎部材および該第2の顎部材の近位部分の周りに配置される延ばされた位置との間で該エンドエフェクタアセンブリに対してスライド可能である、絶縁性管状部材と、
該絶縁性管状部材が該延ばされた位置に配置されている場合、単極のエネルギーを用いて組織を治療するために、組織にエネルギーを印加するように構成された単極部材であって、該延ばされた位置において、該絶縁性管状部材は、該単極部材から該第1の顎部材および該第2の顎部材の該主要部分を絶縁することを容易にする、単極部材と、
該筐体上に配置され、かつ、該絶縁性管状部材に結合された作動ノブであって、該作動ノブは、該引き込まれた位置と該延ばされた位置との間で該絶縁性管状部材を移動させるために第1の位置と第2の位置との間で選択的に移動可能であり、該顎部材のうちの少なくとも一方は、遠位先端部分をさらに含み、該少なくとも一方の顎部材の該遠位先端部分は、該絶縁性管状部材が該延ばされた位置に配置されている場合に組織を治療するために組織に単極のエネルギーを印加するための該単極部材を画定する、作動ノブと
を備えている、鉗子。 - 前記少なくとも一方の顎部材の前記遠位先端部分は、組織の機械的切開を容易にするようにさらに構成されている、請求項4に記載の鉗子。
- 前記絶縁性管状部材は、該絶縁性管状部材に画定されている切り欠きを含み、前記少なくとも一方の顎部材の前記遠位先端部分は、該絶縁性管状部材が延ばされた位置に配置されている場合、該切り欠きを貫通するように構成されている、請求項4に記載の鉗子。
- 鉗子であって、該鉗子は、
筐体と、
該筐体から遠位に延びているシャフトと、
該シャフトの遠位端に配置されたエンドエフェクタアセンブリであって、該エンドエフェクタアセンブリは、第1の顎部材および第2の顎部材を含み、該顎部材のうちの少なくとも一方は、他方に対して、離された位置と、該顎部材間で組織を把持するための接近させられた位置との間で移動可能であり、該第1の顎部材および該第2の顎部材は、双極のエネルギーを用いて組織を治療するために、該顎部材間で把持されている組織を通して、エネルギーを伝導するように構成されている、エンドエフェクタアセンブリと、
単極アセンブリであって、該単極アセンブリは、絶縁性管状部材と、組織を治療するために、組織に単極のエネルギーを印加するように構成された導電性遠位部材とを含み、該導電性遠位部材は、該絶縁性管状部材と係合させられ、かつ、該絶縁性管状部材から遠位方向に延び、該単極アセンブリは、該単極アセンブリが該エンドエフェクタアセンブリの近位に位置決めされる引き込まれた位置と、該絶縁性管状部材が該エンドエフェクタアセンブリの該第1の顎部材および該第2の顎部材を実質的に取り囲み、かつ、該導電性遠位部材が該エンドエフェクタアセンブリの該第1の顎部材および該第2の顎部材から遠位方向に延びる延ばされた位置との間で該エンドエフェクタアセンブリに対して移動可能であり、該延ばされた位置において、該絶縁性管状部材は、該導電性遠位部材から該第1の顎部材および該第2の顎部材を絶縁することを容易にする、単極アセンブリと、
該筐体上に配置され、かつ、該単極アセンブリに結合された作動ノブであって、該作動ノブは、該引き込まれた位置と該延ばされた位置との間で該単極アセンブリを移動させるために第1の位置と第2の位置との間で選択的に移動可能である、作動ノブと
を備えている、鉗子。 - 前記導電性遠位部材は、解放可能に係合可能な遠位先端を含み、該解放可能に係合可能な遠位先端は、前記絶縁性管状部材から遠位方向に延びている、請求項7に記載の鉗子。
- 前記解放可能に係合可能な遠位先端は、複数の遠位先端から選択され、該複数の遠位先端は、勾配付き遠位端を含む第1の遠位先端と、第2の遠位先端であって、該第2の遠位先端から遠位方向に延びているブレードを含む第2の遠位先端と、第3の遠位先端であって、該第3の遠位先端から遠位方向に延びているフックを含む第3の遠位先端と、環状の遠位端を含む第4の遠位先端とのうちの少なくとも1つを含む、請求項8に記載の鉗子。
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EP2679176A1 (en) | 2014-01-01 |
US20160206368A1 (en) | 2016-07-21 |
CN105997195A (zh) | 2016-10-12 |
CN103505282B (zh) | 2016-06-01 |
JP5669886B2 (ja) | 2015-02-18 |
CN203736301U (zh) | 2014-07-30 |
US10709496B2 (en) | 2020-07-14 |
EP2679176B1 (en) | 2022-07-27 |
US9918784B2 (en) | 2018-03-20 |
US9039691B2 (en) | 2015-05-26 |
CN103505282A (zh) | 2014-01-15 |
AU2013205789A1 (en) | 2014-01-16 |
US9649152B2 (en) | 2017-05-16 |
JP2015042315A (ja) | 2015-03-05 |
CN105997195B (zh) | 2019-03-05 |
US20170238992A1 (en) | 2017-08-24 |
US20150250488A1 (en) | 2015-09-10 |
JP2014008406A (ja) | 2014-01-20 |
CA2815875A1 (en) | 2013-12-29 |
CA2815875C (en) | 2019-09-03 |
US9358028B2 (en) | 2016-06-07 |
EP4018943B1 (en) | 2024-04-17 |
EP4018943A1 (en) | 2022-06-29 |
US20140005666A1 (en) | 2014-01-02 |
US20180206906A1 (en) | 2018-07-26 |
AU2013205789B2 (en) | 2015-01-22 |
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