JP5931071B2 - 選択的に関節屈曲が可能なエンドエフェクタを有する手術器具 - Google Patents
選択的に関節屈曲が可能なエンドエフェクタを有する手術器具 Download PDFInfo
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- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
- A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
- A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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- A—HUMAN NECESSITIES
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- A61B17/295—Forceps for use in minimally invasive surgery combined with cutting implements
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- 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
- A61B2017/00371—Multiple actuation, e.g. pushing of two buttons, or two working tips becoming operational
- A61B2017/0038—Simultaneous actuation of two tools by pushing one button or the like
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- A—HUMAN NECESSITIES
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Description
本仮特許出願は、参照によってすべての開示内容が本明細書に組み込まれる、2010年9月24日出願の米国仮出願第61/386,094号に対する優先権と、その利点を主張するものである。
本発明は手術器具に関するものであり、また様々な実施形態において、手動式手術用切断及びステープリング器具に関するものである。
米国特許出願第_____号、名称「Surgical Instrument With Trigger Assembly For Generating Multiple Actuation Motions」、代理人整理番号第END6888USNP3/110378号、
米国特許出願第_____号、名称「Surgical Stapler With Stationary Staple Drivers」、代理人整理番号第END7013USNP/110377号、
米国特許出願第_____号、名称「Surgical Stapler With Floating Anvil」、代理人整理番号第END6841USCIP2/100526CIP2号、
米国特許出願第_____号、名称「Staple Cartridge Including Collapsible Deck Arrangement」、代理人整理番号第END7019USNP/110375号、
米国特許出願第_____号、名称「Staple Cartridge Including Collapsible Deck」、代理人整理番号第END7020USNP/110374号、並びに、
米国特許出願第_____号、名称「Curved End Effector For A Stapling Instrument」、代理人整理番号第END6841USCIP3/100526CIP3号である。
(1) 手術器具であって、
ハンドル組立体と、
前記ハンドル組立体と動作可能に相互作用し、かつ縦軸を画定する細長シャフト組立体と、
前記細長シャフト組立体に動作可能に結合されており、作動運動が加えられると同時に組織を切断及びステープル留めするように構成されている手術用エンドエフェクタと、
前記細長シャフト組立体によって動作可能に支持されている少なくとも1つの関節屈曲部材と、
関節屈曲システムであって、
前記ハンドル組立体に動作可能に支持されており、前記少なくとも1つの関節屈曲部材と動作可能に相互作用する関節屈曲伝達部と、
前記縦軸と横方向には交差しない作動軸を中心として選択的に回転するように、前記ハンドル部材上で回転可能に支持されたアクチュエータ部材であって、前記作動軸を中心として第1の回転方向に前記アクチュエータ部材が回転することで、前記少なくとも1つの関節屈曲部材が、第1の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させることになり、前記作動軸を中心として第2の回転方向に前記アクチュエータ部材が回転することで、前記少なくとも1つの関節屈曲部材が、前記縦軸に対する第2の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させることになるように、前記アクチュエータ部材が前記関節屈曲伝達部と相互作用する、アクチュエータ部材と、を備える、関節屈曲システムとを備える、手術器具。
(2) 前記細長シャフト組立体は、その中に実質的に可撓性の関節屈曲接合区間を有し、該関節屈曲接合区間は前記手術用エンドエフェクタに結合されている、実施態様1に記載の手術器具。
(3) 前記少なくとも1つの関節屈曲部材は、
前記細長シャフト組立体によって動作可能に支持されており、前記縦軸の第1の側で前記実質的に可撓性の関節屈曲接合区間の一部分に結合されている第1の関節屈曲バンド組立体であって、前記関節屈曲伝達部と動作可能に相互作用する、第1の関節屈曲バンド組立体と、
前記細長シャフト組立体によって動作可能に支持されており、前記縦軸の第2の側で前記実質的に可撓性の関節屈曲接合区間の前記一部分に結合されている第2の関節屈曲バンド組立体であって、前記関節屈曲伝達部と動作可能に相互作用する、第2の関節屈曲バンド組立体と、を備える、実施態様2に記載の手術器具。
(4) 前記作動軸は前記縦軸と実質的に同軸である、実施態様1に記載の手術器具。
(5) 前記関節屈曲伝達部は、
前記ハンドル組立体内に移動可能に支持されている第1の関節屈曲ディスクであって、第1の回転方向に前記アクチュエータ部材が回転することで前記第1の関節屈曲バンド組立体が第1の軸方向に移動するように、前記アクチュエータ部材及び前記第1の関節屈曲バンド組立体と相互作用する、第1の関節屈曲ディスクと、
前記ハンドル組立体内に移動可能に支持されている第2の関節屈曲ディスクであって、前記第1の回転方向に前記アクチュエータ部材が回転することで前記第2の関節屈曲ディスクが、前記第1の軸方向とは反対である第2の軸方向に移動するように、前記アクチュエータ部材及び前記第2の関節屈曲バンド組立体と相互作用する、第2の関節屈曲ディスクと、を備える、実施態様4に記載の手術器具。
(7) 前記第1及び第2の関節屈曲ディスクは前記アクチュエータ部材とネジ係合する、実施態様5に記載の手術器具。
(8) 前記アクチュエータ部材は、前記作動軸を中心として前記ハンドル組立体に対して選択的に回転するように前記ハンドル組立体上に回転可能に支持されるアクチュエータホイールを含み、前記アクチュエータホイールは、前記第1の関節屈曲ディスクとネジ係合する第1のネジ山と、前記第2の関節屈曲部とネジ係合する第2のネジ山と、を有し、前記第1のネジ山は第1のネジ方向を有し、前記第2のネジ山は、前記第1のネジ方向とは反対である第2のネジ方向を有する、実施態様7に記載の手術器具。
(9) 前記手術用エンドエフェクタは、その中に埋込み型ステープルカートリッジを支持するように構成されている、実施態様1に記載の手術器具。
(10) 前記細長シャフト組立体によって動作可能に支持されているナイフバーと、
前記ハンドル組立体によって動作可能に支持されている発射伝達部と、
前記ハンドル組立体によって動作可能に支持された発射トリガであって、前記手術用エンドエフェクタを貫いて前記ナイフバーを遠位方向に駆動するために、前記発射伝達部に作動運動を加えるように構成されている、発射トリガと、を更に備える、実施態様1に記載の手術器具。
細長チャネルと、
前記細長チャネル内に動作可能に支持された手術用ステープルカートリッジと、
前記細長チャネルに対して開位置と閉位置との間で移動可能に支持されたアンビルと、
発射動作が加えられると同時に、前記細長チャネルの近位端部から前記細長チャネルの遠位端部へと移動可能に進むように支持されたナイフバーと、
ハンドル組立体と、
前記ハンドル組立体及び前記細長チャネルに結合されており、前記ナイフバーの少なくとも一部分を動作可能に支持する細長シャフト組立体であって、縦軸を画定しており、前記発射動作を前記ナイフバーに加えるように構成されている、細長シャフト組立体と、
前記ハンドル組立体上に動作可能に支持されており、前記発射動作を前記細長シャフト組立体に加えるように構成されているトリガ組立体と、
関節屈曲システムであって、
前記ハンドル組立体によって動作可能に支持されており、前記細長シャフト組立体と動作可能に相互作用する関節屈曲伝達部と、
前記縦軸とは交差しない作動軸を中心として選択的に回転するように、前記ハンドル部材上に回転可能に支持されたアクチュエータ部材であって、前記作動軸を中心として第1の回転方向に前記アクチュエータ部材が回転することで、前記細長シャフト組立体が、第1の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させ、前記作動軸を中心として第2の回転方向に前記アクチュエータ部材が回転することで、前記細長シャフト組立体が、前記縦軸に対する第2の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させるように、前記アクチュエータ部材が前記関節屈曲伝達部と相互作用する、アクチュエータ部材と、を備える、関節屈曲システムとを備える、手術用切断及び締結器具。
(12) 前記手術用ステープルカートリッジは、押付け可能でかつ埋込み可能であるステープルカートリッジ組立体を備える、実施態様11に記載の手術用切断及び締結器具。
(13) 前記細長シャフト組立体は、前記ハンドル組立体に対して前記縦軸を中心として選択的に回転可能である、実施態様11に記載の手術用切断及び締結器具。
(14) 前記ナイフバーは、
前記細長シャフト組立体内で移動可能に支持された細長可撓性区間と、
前記細長可撓性区間に結合されており、前記細長チャネルを貫いて軸方向に進むように構成されている切断ヘッドであって、その上に切断用表面を有し、前記切断ヘッドが前記細長チャネルの近位端部から前記細長チャネルの遠位端部に駆動されるとき、前記アンビルと押付けで係合するように構成されている、切断ヘッドと、を備える、実施態様11に記載の手術用切断及び締結器具。
(15) 前記細長シャフト組立体は、
前記ハンドル組立体と動作可能に相互作用する、実質的に剛性の近位シャフト区間と、
前記実質的に剛性の近位シャフト区間と前記細長チャネルとの間に延びる、実質的に可撓性の関節屈曲接合部と、を備える、実施態様11に記載の手術用切断及び締結器具。
前記実質的に剛性の近位シャフト区間によって動作可能に支持されており、前記縦軸の第1の側で前記実質的に可撓性の関節屈曲接合部と前記細長チャネルとの一方に結合されている第1の関節屈曲バンド組立体であって、前記関節屈曲伝達部と動作可能に相互作用する、第1の関節屈曲バンド組立体と、
前記細長シャフト組立体によって動作可能に支持されており、前記縦軸の第2の側で前記実質的に可撓性の関節屈曲接合区間と前記細長チャネルとの一方に結合されている第2の関節屈曲バンド組立体であって、前記第2の関節屈曲バンド組立体は、前記関節屈曲伝達部と動作可能に相互作用する、第2の関節屈曲バンド組立体と、を備える、実施態様15に記載の手術用切断及び締結器具。
(17) 前記関節屈曲伝達部は、
前記ハンドル組立体内で動作可能に支持されており、前記アクチュエータ部材及び前記第1の関節屈曲バンド組立体と相互作用する第1の関節屈曲ディスクと、
前記ハンドル組立体内で動作可能に支持されており、前記アクチュエータ部材及び前記第2の関節屈曲バンド組立体と相互作用する第2の関節屈曲ディスクと、を備え、
前記第1の回転方向に前記アクチュエータ部材が回転することで、前記第1及び第2の関節屈曲ディスクが互いに向かって軸方向に移動して、第1の軸方向にて前記第1の関節屈曲バンド組立体に関節屈曲運動が、前記第1の軸方向と反対の第2の軸方向にて前記第2の関節屈曲バンド組立体に別の関節屈曲運動が加えられることになる、実施態様16に記載の手術用切断及び締結器具。
(18) 前記第2の回転方向に前記アクチュエータ部材が回転することで、前記第1及び第2の関節屈曲ディスクが互いに離れる向きに軸方向に移動して、前記第2の軸方向にて前記第1の関節屈曲バンド組立体に関節屈曲運動が、前記第1の軸方向にて前記第2の関節屈曲バンド組立体に別の関節屈曲運動が加えられることになる、実施態様17に記載の手術用切断及び締結器具。
(19) 前記アクチュエータ部材が中立位置にあることをユーザーに指示するために、前記アクチュエータ部材と相互作用する手段を更に含み、前記中立位置では、前記手術用エンドエフェクタは前記縦軸上に実質的に同軸に整列する、実施態様11に記載の手術用切断及び締結器具。
(20) エンドエフェクタを備える手術用切断及び締結器具であって、
前記エンドエフェクタは、
内部にステープルカートリッジを動作可能に支持するように構成されたチャネルと、
前記チャネルに対して移動可能に支持されたアンビルとを備え、前記手術用切断及び締結器具は更に、
縦軸を画定する細長シャフト組立体を備え、前記細長シャフト組立体は、
実質的に剛性の近位シャフト区間と、
前記実質的に剛性の遠位シャフト部分及び前記エンドエフェクタの前記チャネルに結合された実質的に可撓性の関節屈曲区間と、
前記実質的に可撓性の関節屈曲区間と対応する実質的に可撓性の部分を有し、遠位端部に形成された組織切断ヘッドを有するナイフバーと、
作動運動を加えるように前記ナイフバーと動作可能に相互作用するナイフチューブと、
前記実質的に剛性の近位シャフト区間によって動作可能に支持されており、前記縦軸の第1の側で前記実質的に可撓性の関節屈曲接合部と前記チャネルとの一方に結合されている第1の関節屈曲バンド組立体と、
前記実質的に剛性の近位シャフト区間によって動作可能に支持されており、前記縦軸の第2の側で前記実質的に可撓性の関節屈曲接合区間と前記細長チャネルとの前記一方に結合されている第2の関節屈曲バンド組立体とを備え、前記手術用切断及び締結器具は更に、
前記実質的に剛性の近位シャフト区間に動作可能に結合されたハンドル組立体と、
前記ハンドル組立体上に回転可能に支持されたアクチュエータホイールと、
前記ハンドル組立体内で動作可能に支持されており、前記アクチュエータホイール及び前記第1の関節屈曲バンド組立体と相互作用する第1の関節屈曲ディスクと、
前記ハンドル組立体内で動作可能に支持されており、前記アクチュエータホイール及び前記第2の関節屈曲バンド組立体と相互作用する第2の関節屈曲ディスクであって、前記第1及び第2の関節屈曲ディスクは、第1の回転方向に前記アクチュエータホイールが回転することで、前記第1及び第2の関節屈曲ディスクが互いに向かって軸方向に移動して、第1の軸方向にて前記第1の関節屈曲バンド組立体に関節屈曲運動が、前記第1の軸方向と反対の第2の軸方向にて前記第2の関節屈曲バンド組立体に別の関節屈曲運動が加えられるように構成されている、第2の関節屈曲ディスクと、
前記ハンドル組立体上に動作可能に支持されており、前記ナイフチューブと相互作用する発射トリガであって、作動運動を前記発射トリガに加えることで、前記作動運動が前記ナイフチューブに加えられるようになっている、発射トリガと、を備える、手術用切断及び締結器具。
Claims (5)
- 手術器具であって、
ハンドル組立体と、
前記ハンドル組立体と動作可能に相互作用し、かつ縦軸を画定する細長シャフト組立体と、
前記細長シャフト組立体に動作可能に結合されており、作動運動が加えられると同時に組織を切断及びステープル留めするように構成されている手術用エンドエフェクタと、
前記細長シャフト組立体によって動作可能に支持されている少なくとも1つの関節屈曲部材と、
関節屈曲システムであって、
前記ハンドル組立体に動作可能に支持されており、前記少なくとも1つの関節屈曲部材と動作可能に相互作用する関節屈曲伝達部と、
前記縦軸と横方向には交差しない作動軸を中心として選択的に回転するように、前記ハンドル部材上で回転可能に支持されたアクチュエータ部材であって、前記作動軸を中心として第1の回転方向に前記アクチュエータ部材が回転することで、前記少なくとも1つの関節屈曲部材が、第1の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させることになり、前記作動軸を中心として第2の回転方向に前記アクチュエータ部材が回転することで、前記少なくとも1つの関節屈曲部材が、前記縦軸に対する第2の関節屈曲方向に前記縦軸に対して前記手術用エンドエフェクタを関節屈曲させることになるように、前記アクチュエータ部材が前記関節屈曲伝達部と相互作用する、アクチュエータ部材と、を備える、関節屈曲システムとを備え、
前記細長シャフト組立体は、その中に実質的に可撓性の関節屈曲接合区間を有し、該関節屈曲接合区間は前記手術用エンドエフェクタに結合され、
前記少なくとも1つの関節屈曲部材は、
前記細長シャフト組立体によって動作可能に支持されており、前記縦軸の第1の側で前記実質的に可撓性の関節屈曲接合区間の一部分に結合されている第1の関節屈曲バンド組立体であって、前記関節屈曲伝達部と動作可能に相互作用する、第1の関節屈曲バンド組立体と、
前記細長シャフト組立体によって動作可能に支持されており、前記縦軸の第2の側で前記実質的に可撓性の関節屈曲接合区間の前記一部分に結合されている第2の関節屈曲バンド組立体であって、前記関節屈曲伝達部と動作可能に相互作用する、第2の関節屈曲バンド組立体と、を備え
前記関節屈曲伝達部は、
前記ハンドル組立体内に移動可能に支持されている第1の関節屈曲ディスクであって、第1の回転方向に前記アクチュエータ部材が回転することで前記第1の関節屈曲バンド組立体が第1の軸方向に移動するように、前記アクチュエータ部材及び前記第1の関節屈曲バンド組立体と相互作用する、第1の関節屈曲ディスクと、
前記ハンドル組立体内に移動可能に支持されている第2の関節屈曲ディスクであって、前記第1の回転方向に前記アクチュエータ部材が回転することで前記第2の関節屈曲ディスクが、前記第1の軸方向とは反対である第2の軸方向に移動するように、前記アクチュエータ部材及び前記第2の関節屈曲バンド組立体と相互作用する、第2の関節屈曲ディスクと、を備え、
前記第1及び第2の関節屈曲ディスクは前記アクチュエータ部材とネジ係合し、
前記アクチュエータ部材は、前記作動軸を中心として前記ハンドル組立体に対して選択的に回転するように前記ハンドル組立体上に回転可能に支持されるアクチュエータホイールを含み、前記アクチュエータホイールは、前記第1の関節屈曲ディスクとネジ係合する第1のネジ山と、前記第2の関節屈曲ディスクとネジ係合する第2のネジ山と、を有し、前記第1のネジ山は第1のネジ方向を有し、前記第2のネジ山は、前記第1のネジ方向とは反対である第2のネジ方向を有する、手術器具。 - 前記作動軸は前記縦軸と実質的に同軸である、請求項1に記載の手術器具。
- 前記アクチュエータ部材が第2の回転方向に回転することで、前記第1の関節屈曲バンド組立体が前記第2の軸方向に移動し、前記第2の関節屈曲バンド組立体が前記第1の軸方向に移動するように、前記第1の関節屈曲ディスクが前記アクチュエータ部材と動作可能に相互作用する、請求項1に記載の手術器具。
- 前記手術用エンドエフェクタは、その中に埋込み型ステープルカートリッジを支持するように構成されている、請求項1に記載の手術器具。
- 前記細長シャフト組立体によって動作可能に支持されているナイフバーと、
前記ハンドル組立体によって動作可能に支持されている発射伝達部と、
前記ハンドル組立体によって動作可能に支持された発射トリガであって、前記手術用エンドエフェクタを貫いて前記ナイフバーを遠位方向に駆動するために、前記発射伝達部に作動運動を加えるように構成されている、発射トリガと、を更に備える、請求項1に記載の手術器具。
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