JP5944638B2 - 外科手術器具のための組織停止部 - Google Patents
外科手術器具のための組織停止部 Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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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
- A61B17/068—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
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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
- A61B2017/07214—Stapler heads
- A61B2017/07221—Stapler heads curved
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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
- A61B17/068—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
- A61B2017/07214—Stapler heads
- A61B2017/07271—Stapler heads characterised by its cartridge
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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
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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- 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
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/036—Abutting means, stops, e.g. abutting on tissue or skin abutting on tissue or skin
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Description
（関連出願の参照）
本出願は、２０１０年１０月１日に出願された米国仮特許出願第６１／３８８，６５０号に対する優先権およびその利益を主張し、この仮特許出願の内容全体が本明細書に参照によって援用される。
本出願は、２０１０年１０月１日に出願された米国仮特許出願第６１／３８８，６５０号に対する優先権およびその利益を主張し、この仮特許出願の内容全体が本明細書に参照によって援用される。
（背景）
（技術分野）
本開示は、概して外科手術器具に関し、より具体的には組織を外科的に接合する外科手術器具に関する。
（技術分野）
本開示は、概して外科手術器具に関し、より具体的には組織を外科的に接合する外科手術器具に関する。
（関連技術の背景）
圧縮された、生きている組織を通ってステープルの平行した列を適用するために用いられる外科手術ステープリング器具は、当該分野において公知である。これらの外科手術器具は、処理または切除の前に組織または器官を閉じるために、胸部処置および腹部処置において器官を塞ぐために、そして吻合において組織を固定するために一般的に用いられる。
圧縮された、生きている組織を通ってステープルの平行した列を適用するために用いられる外科手術ステープリング器具は、当該分野において公知である。これらの外科手術器具は、処理または切除の前に組織または器官を閉じるために、胸部処置および腹部処置において器官を塞ぐために、そして吻合において組織を固定するために一般的に用いられる。
典型的には、そのような外科手術ステープリング器具は、アンビルアセンブリと、外科手術ステープルの配列を支持するカートリッジアセンブリと、アンビルとカートリッジとアンビルアセンブリとを接近させる接近機構と、カートリッジアセンブリから外科手術ステープルを射出する発射機構とを含む。
使用時、外科医は、通常最初にアンビル部材とカートリッジ部材とを接近させる。次に、外科医は、器具を発射して組織にステープルを配置し得る。さらに、外科医は、同じ器具または別個の器具を用いて、ステープルの列に隣接するかまたはステープルの列の間の組織を切り得る。特定の外科手術ステープリング器具において、器具は、アンビルとカートリッジが接近させられている間、ステープルカートリッジからステープルを順次に射出する。ステープルは、組織を通って駆動され、アンビルに対して形成される。
（概要）
本開示は、組織を外科的に接合する外科手術器具に関し、開示される。外科手術器具は、ハンドルアセンブリと、細長い部分と、一対の向かい合うジョー部材と、組織停止部とを含む。ハンドルアセンブリは、可動ハンドルを含む。細長い部分は、ハンドルアセンブリから遠位に延び、長手方向軸を規定する。一対の向かい合うジョー部材は、細長い部分に動作可能に連結され、細長い部分から遠位に延びる。一対の向かい合うジョー部材は、第１のジョー部材と第２のジョー部材とを含む。組織停止部は、第１のジョー部材と機械的に係合され、一対の向かい合うジョー部材間に組織を保持するように構成される。組織停止部は、組織停止部の停止部分が第１のジョー部材の組織接触表面と第２のジョー部材の組織接触表面との間に配置される第１の位置と停止部分が第１のジョー部材の組織接触表面と第１のジョー部材の下部表面との間にある第２の位置との間で可動であ
る。組織停止部の一部分は、プレス加工された金属部から作られ、組織停止部の一部分はオーバーモールドのプラスチック部から作られる。
本開示は、組織を外科的に接合する外科手術器具に関し、開示される。外科手術器具は、ハンドルアセンブリと、細長い部分と、一対の向かい合うジョー部材と、組織停止部とを含む。ハンドルアセンブリは、可動ハンドルを含む。細長い部分は、ハンドルアセンブリから遠位に延び、長手方向軸を規定する。一対の向かい合うジョー部材は、細長い部分に動作可能に連結され、細長い部分から遠位に延びる。一対の向かい合うジョー部材は、第１のジョー部材と第２のジョー部材とを含む。組織停止部は、第１のジョー部材と機械的に係合され、一対の向かい合うジョー部材間に組織を保持するように構成される。組織停止部は、組織停止部の停止部分が第１のジョー部材の組織接触表面と第２のジョー部材の組織接触表面との間に配置される第１の位置と停止部分が第１のジョー部材の組織接触表面と第１のジョー部材の下部表面との間にある第２の位置との間で可動であ
る。組織停止部の一部分は、プレス加工された金属部から作られ、組織停止部の一部分はオーバーモールドのプラスチック部から作られる。
開示される実施形態において、組織停止部の停止部分は、スカロップ部分を含む。開示される実施形態において、組織停止部のスカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む。
開示される実施形態において、組織停止部は、一対の横壁を含む。開示される実施形態において、停止部分は、各横壁の近位エッジに配置される。
本開示はまた、外科手術器具を解除可能に係合するように構成されるローディングユニットに関する。ローディングユニットは、本体部分と、一対のジョー部材と、組織停止部とを含む。本体部分は、長手方向軸を規定し、外科手術器具の細長い部分を解除可能に係合するように構成される近位部分を含む。一対のジョー部材は、本体部分から遠位に延びる。ジョー部材の少なくとも１つは、開放位置とジョー部材間に体組織を係合する接近位置との間で他方に対して可動である。一対のジョー部材は、第１のジョー部材と第２のジョー部材とを含む。組織停止部は、第１のジョー部材と機械的に係合され、一対の向かい合うジョー部材間に組織を保持するように構成される。組織停止部は、組織停止部の停止部分が第１のジョー部材の組織接触表面と第２のジョー部材の組織接触表面との間に配置される第１の位置と停止部分が第１のジョー部材の組織接触表面と第１のジョー部材の下部表面との間にある第２の位置との間で可動である。組織停止部の一部分は、プレス加工された金属部から作られ、組織停止部の一部分はオーバーモールドのプラスチック部から作られる。
開示される実施形態において、ローディングユニットの組織停止部の前記停止部分は、スカロップ部分を含む。開示される実施形態において、組織停止部のスカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む。
開示される実施形態において、ローディングユニットの組織停止部は、一対の横壁を含む。開示される実施形態において、停止部分は、各横壁の近位エッジに配置される。
本開示はまた、外科手術器具と共に使用する組織停止部に関する。組織停止部は、プレス加工された金属部分と、オーバーモールドのプラスチック部分とを含む。組織停止部は、外科手術器具のジョー部材と機械的に係合され、外科手術器具の向かい合うジョー部材間に組織を保持するように構成される。
開示される実施形態において、組織停止部は、一対の横壁を含む。開示される実施形態において、停止部分は、各横壁の近位エッジに配置される。開示される実施形態において、停止部分は、スカロップ部分を含む。開示される実施形態において、組織停止部のスカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む。
例えば、本発明は以下の項目を提供する。
（項目１）
組織を外科的に接合する外科手術器具であって、該外科手術器具は、
可動ハンドルを含むハンドルアセンブリと、
該ハンドルアセンブリから遠位に延び、長手方向軸を規定する細長い部分と、
該細長い部分に動作可能に連結され、該細長い部分から遠位に延びる一対の向かい合うジョー部材であって、該一対の向かい合うジョー部材は、第１のジョー部材と第２のジョー部材とを含む、一対の向かい合うジョー部材と、
該第１のジョー部材と機械的に係合され、該一対の向かい合うジョー部材間に組織を保持するように構成される組織停止部であって、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部の一部分は、プレス加工された金属部から作られ、該組織停止部の一部分はオーバーモールドのプラスチック部から作られる、組織停止部と
を備えている、外科手術器具。
（項目２）
上記組織停止部の上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の外科手術器具。
（項目３）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載の外科手術器具。
（項目４）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載の外科手術器具。
（項目５）
上記停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載の外科手術器具。
（項目６）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の外科手術器具。
（項目７）
外科手術器具を解除可能に係合するように構成されるローディングユニットであって、該ローディングユニットは、
長手方向軸を規定する本体部分であって、該本体部分は、該外科手術器具の細長い部分を解除可能に係合するように構成される近位部分を含む、本体部分と、
該本体部分から遠位に延びる一対のジョー部材であって、該ジョー部材の少なくとも１つは、開放位置と該ジョー部材間に体組織を係合する接近位置との間で他方に対して可動であり、該一対のジョー部材は第１のジョー部材と第２のジョー部材とを含む、一対のジョー部材と、
該第１のジョー部材と機械的に係合され、該一対の向かい合うジョー部材間に組織を保持するように構成される組織停止部であって、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部の一部分は、プレス加工された金属部から作られ、該組織停止部の一部分はオーバーモールドのプラスチック部から作られる、組織停止部と
を備えている、ローディングユニット。
（項目８）
上記組織停止部の上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載のローディングユニット。
（項目９）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載のローディングユニット。
（項目１０）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載のローディングユニット。
（項目１１）
上記停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載のローディングユニット。
（項目１２）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載のローディングユニット。
（項目１３）
外科手術器具と共に使用する組織停止部であって、該組織停止部は、
プレス加工された金属部分と、
オーバーモールドのプラスチック部分と
を備え、
該組織停止部は、該外科手術器具のジョー部材と機械的に係合され、該外科手術器具の向かい合うジョー部材間に組織を保持するように構成される、組織停止部。
（項目１４）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載の組織停止部。
（項目１５）
停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載の組織停止部。
（項目１６）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の組織停止部。
（項目１７）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載の組織停止部。
（項目１）
組織を外科的に接合する外科手術器具であって、該外科手術器具は、
可動ハンドルを含むハンドルアセンブリと、
該ハンドルアセンブリから遠位に延び、長手方向軸を規定する細長い部分と、
該細長い部分に動作可能に連結され、該細長い部分から遠位に延びる一対の向かい合うジョー部材であって、該一対の向かい合うジョー部材は、第１のジョー部材と第２のジョー部材とを含む、一対の向かい合うジョー部材と、
該第１のジョー部材と機械的に係合され、該一対の向かい合うジョー部材間に組織を保持するように構成される組織停止部であって、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部の一部分は、プレス加工された金属部から作られ、該組織停止部の一部分はオーバーモールドのプラスチック部から作られる、組織停止部と
を備えている、外科手術器具。
（項目２）
上記組織停止部の上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の外科手術器具。
（項目３）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載の外科手術器具。
（項目４）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載の外科手術器具。
（項目５）
上記停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載の外科手術器具。
（項目６）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の外科手術器具。
（項目７）
外科手術器具を解除可能に係合するように構成されるローディングユニットであって、該ローディングユニットは、
長手方向軸を規定する本体部分であって、該本体部分は、該外科手術器具の細長い部分を解除可能に係合するように構成される近位部分を含む、本体部分と、
該本体部分から遠位に延びる一対のジョー部材であって、該ジョー部材の少なくとも１つは、開放位置と該ジョー部材間に体組織を係合する接近位置との間で他方に対して可動であり、該一対のジョー部材は第１のジョー部材と第２のジョー部材とを含む、一対のジョー部材と、
該第１のジョー部材と機械的に係合され、該一対の向かい合うジョー部材間に組織を保持するように構成される組織停止部であって、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部の一部分は、プレス加工された金属部から作られ、該組織停止部の一部分はオーバーモールドのプラスチック部から作られる、組織停止部と
を備えている、ローディングユニット。
（項目８）
上記組織停止部の上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載のローディングユニット。
（項目９）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載のローディングユニット。
（項目１０）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載のローディングユニット。
（項目１１）
上記停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載のローディングユニット。
（項目１２）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載のローディングユニット。
（項目１３）
外科手術器具と共に使用する組織停止部であって、該組織停止部は、
プレス加工された金属部分と、
オーバーモールドのプラスチック部分と
を備え、
該組織停止部は、該外科手術器具のジョー部材と機械的に係合され、該外科手術器具の向かい合うジョー部材間に組織を保持するように構成される、組織停止部。
（項目１４）
上記組織停止部は、一対の横壁を含む、上記項目のいずれかに記載の組織停止部。
（項目１５）
停止部分は、各横壁の近位エッジに配置される、上記項目のいずれかに記載の組織停止部。
（項目１６）
上記停止部分は、スカロップ部分を含む、上記項目のいずれかに記載の組織停止部。
（項目１７）
上記組織停止部の上記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、上記項目のいずれかに記載の組織停止部。
（摘要）
組織を外科的に接合する外科手術器具が開示される。外科手術器具は、ハンドルアセンブリと、ハンドルアセンブリから遠位に延びる細長い部分と、一対の向かい合うジョー部材と、組織停止部とを含む。組織停止部は、第１のジョー部材と機械的に係合され、ジョー部材間に組織を保持するように構成される。組織停止部は、組織停止部の停止部分が第１のジョー部材の組織接触表面と第２のジョー部材の組織接触表面との間に配置される第１の位置と停止部分が第１のジョー部材の組織接触表面と第１のジョー部材の下部表面との間にある第２の位置との間で可動である。組織停止部の一部分は、プレス加工された金属部から作られ、組織停止部の一部分はオーバーモールドのプラスチック部から作られる。
組織を外科的に接合する外科手術器具が開示される。外科手術器具は、ハンドルアセンブリと、ハンドルアセンブリから遠位に延びる細長い部分と、一対の向かい合うジョー部材と、組織停止部とを含む。組織停止部は、第１のジョー部材と機械的に係合され、ジョー部材間に組織を保持するように構成される。組織停止部は、組織停止部の停止部分が第１のジョー部材の組織接触表面と第２のジョー部材の組織接触表面との間に配置される第１の位置と停止部分が第１のジョー部材の組織接触表面と第１のジョー部材の下部表面との間にある第２の位置との間で可動である。組織停止部の一部分は、プレス加工された金属部から作られ、組織停止部の一部分はオーバーモールドのプラスチック部から作られる。
本開示される外科手術器具の様々な実施形態は、図面を参照して本明細書に開示される。
（詳細な説明）
本開示される外科手術器具の実施形態は、図面を参照して詳細に説明され、いくつかの図の各々において、似ている参照数字は、類似するかまたは同一の要素を示す。図面およびそれに続く説明において、用語「近位」は、オペレータに最も近い、外科手術器具の端部をいい、一方、用語「遠位」は、オペレータから最も遠い、外科手術器具の端部をいう。
本開示される外科手術器具の実施形態は、図面を参照して詳細に説明され、いくつかの図の各々において、似ている参照数字は、類似するかまたは同一の要素を示す。図面およびそれに続く説明において、用語「近位」は、オペレータに最も近い、外科手術器具の端部をいい、一方、用語「遠位」は、オペレータから最も遠い、外科手術器具の端部をいう。
当業者によって理解されるように、描かれる外科手術器具は、ステープルを発射するが、クリップおよび二部品ファスナーなどの任意の他の適切なファスナーを発射するように適合され得る。さらに、開示される組織停止部は、電気外科手術鉗子と共に用いられ得る。電気外科手術鉗子のさらなる詳細は、２００３年２月２０日に出願され、名称が「ＶＥＳＳＥＬ ＳＥＡＬＥＲ ＡＮＤ ＤＩＶＩＤＥＲ ＡＮＤ ＭＥＴＨＯＤ ＯＦ ＭＡＮＵＦＡＣＴＵＲＩＮＧ ＴＨＥ ＳＡＭＥ」である、共有に係る特許出願第１０／３６９，８９４号に説明され、この特許出願の内容全体が本明細書に参照によって援用される。
図１を参照すると、参照数字１００は、本開示の外科手術器具の一実施形態を示す。簡潔さの利益のために、本開示は、外科手術器具１００のエンドエフェクタおよび組織停止部に焦点を合わせる。２００７年１１月２８日に出願された米国特許出願公開第２００８／０１０５７３０号、２００８年１月８に出願された第２００８／０１１０９６０号、２００８年１月２４日に出願された第２００８／０１４２５６５号、２００７年１０月１５日に出願された第２００８／００４１９１６号、および２００７年４月１０日に出願された第１１／７８６，１９８号は、他の外科手術固定アセンブリの構造および動作を詳細に説明し、これらの特許出願の内容全体が本明細書によって本明細書に参照によって援用される。
例示される実施形態で開示される外科手術器具１００は、組織をクランプ留めし、固定し、かつ／または切るように構成される。図１に示されるように、概して、外科手術器具１００は、ハンドルアセンブリ１１０と、ハンドルセンブリ１１０から遠位に延び、長手方向軸「Ａ−Ａ」を規定する細長い部分１２０と、（１回使用のローディングユニット（「ＳＵＬＵ」）および使い捨てのローディングユニット（「ＤＬＵ」）を総称していう）ローディングユニット１８０とを含む。図２を参照すると、ローディングユニット１８０は、近位本体部分１５６と、ツールアセンブリ１５０とを含む。近位本体部分１５６は、例えば、差込みカップリング、掛金、移動止めまたはスナップ嵌めなどの様々な取り付け機能を用いて外科手術器具１００の細長い部分１２０に解除可能に取り付くように構成される。他の実施形態において、器具は、細長い部分に永続的に取り付けられるジョーを有し、ステープルカートリッジなどの交換可能カートリッジは、ジョーのうちの１つに装填され、取り外され、再装填され得る。
ツールアセンブリ１５０は、エンドエフェクタ１５４と、組織停止部１７０とを含む。本体部分１５６の遠位部分１２４に隣接して配置されるエンドエフェクタ１５４は、第１のジョー部材１３０と、第２のジョー部材１４０とを含む。図１および図２に示されるように、第１のジョー部材１３０および第２のジョー部材１４０の各々は、長手方向軸「Ａ−Ａ」に対して長手方向に湾曲している。直線のジョー部材と比較して、湾曲したジョー部材は、例えば低位前方切除術（「ＬＡＲ」）中などにおける低位骨盤領域へのアクセスを容易にすることを助け得る。さらに、湾曲したジョー部材を含めることは、外科手術部位に対する視覚化の向上を可能にし得、また外科医が自分の手で標的組織またはジョー部材自体を操作するためのより多くの余地を可能にし得る。例示される実施形態は、湾曲しているジョー部材を描くが、組織停止部１７０が直線のジョー部材と共に用いられ得ることは本開示の範囲内であり、想定される。
ジョー部材１３０、１４０のうちの少なくとも１つは、間隔を空けて配置された位置と接近した位置との間でもう一方のジョー部材（１３０または１４０）に対して動くように適合される。例示される実施形態において、第１のジョー部材１３０はカートリッジアセンブリ１３２を含み、第２のジョー部材１４０はアンビルアセンブリ１４２を含む。カートリッジアセンブリ１３２は、例えば、可動ハンドル１１２を作動すると、間隔を空けて配置された位置と接近した位置との間でアンビルセンブリ１４２に対して動く。カートリッジアセンブリ１３２は、アンビルアセンブリ１４２に対して旋回可能に可動であるように示される一方、アンビルアセンブリ１４２は、カートリッジアセンブリ１３２に対して旋回可能に取り付けられ得る。
ハンドルアセンブリ１１０は、固定ハンドル１１４と、可動ハンドル１１２とを含む。可動ハンドル１１２は、固定ハンドル１１４の方にまたは固定ハンドル１１４から離れるように旋回して動くように適合される。さらに可動ハンドル１１２は、間隔を空けて配置された位置と接近した位置との間で可動ハンドル１１２の少なくとも一部の作動をカートリッジアセンブリ１３２およびアンビルアセンブリ１４２のうちの少なくとも１つの旋回動作に変換するように適合される機構を介して、アンビルセンブリ１４２に動作可能に接続される。当業者によって認識されるように、可動ハンドル１１２をツールアセンブリ１５０に動作可能に連結するために任意の従来の作動機構が用いられ得る。
図２を参照すると、カートリッジアセンブリ１３２は、組織接触表面１３４と、複数のファスナー保持スロット１３６とを有する。組織接触表面１３４は、全体的にアンビルアセンブリ１４２に面し、手術時、アンビルセンブリ１４２がカートリッジセンブリ１３２に接近させられたとき、組織を係合する。ファスナー保持スロット１３６は、組織接触表面１３４に沿って列になって配置され、各ファスナー保持スロット１３６は、ファスナー（図示されていない）を解除可能に保持するように適合される。例えば、可動ハンドル１１２が固定ハンドル１１４の方に旋回させられると、ファスナーは、ファスナー保持スロット１３６から射出され、アンビルアセンブリ１４２の方に動く。
カートリッジアセンブリ１３２はまた、ナイフ（図示されていない）または任意の他の適切な切断ツールをスライド可能に受けるように適合されるナイフチャネル１３８（図３）を含む。ナイフチャネル１３８は、ステープルカートリッジに規定され、ファスナー保持スロット１３６の列の間に配置され、組織接触表面１３４に沿って延びる。動作時、可動ハンドル１１２が固定ハンドル１１４の方に旋回すると、ナイフはナイフチャネル１３８を通ってスライドする。あるいは、ナイフチャネル１３８を通ってナイフを駆動するために他の機構が用いられ得る。
開示される実施形態において、ハンドルアセンブリ１１０は、ファスナー保持スロット１３６からファスナーを配備し、ナイフチャネル１３８に沿ってナイフを前進させる作動機構を含む。この作動機構は、可動ハンドル１１２に動作可能に接続される発射ロッド（図示されていない）を含む。動作時、固定ハンドル１１４の方へ可動ハンドル１１２を旋回させることは、発射ロッドを遠位に前進させる。発射ロッドは次に、ツールアセンブリ１５０内に少なくとも部分的に位置を決められる軸方向駆動アセンブリに動作可能に連結される。軸方向駆動アセンブリは、発射ロッドの遠位並進に応答して遠位に動くように構成させる。軸方向駆動アセンブリは、ナイフと、上部部材と、下部部材とを組み込む駆動ビームを含む。駆動ビームの上部部材はアンビルアセンブリを係合し、駆動ビームの下部部材はカートリッジアセンブリを係合するので、軸方向駆動アセンブリの遠位並進はカートリッジアセンブリ１３２の方にアンビルアセンブリ１４２を旋回させる。さらに軸方向駆動アセンブリは、カートリッジアセンブリ１３２内に配置される作動スレッドを遠位方向に押し、一方、作動スレッドはエンドエフェクタ１５４を通って遠位に並進する。作動スレッドがカートリッジアセンブリ１３２を通って遠位に前進すると、この作動スレッドは、ファスナー保持スロット１３６から出るようにファスナーを推進する。特定の実施形態において、軸方向駆動アセンブリは、軸方向駆動アセンブリの遠位部分に取り付けられるナイフまたは刃を含む。動作時、軸方向駆動アセンブリがエンドエフェクタ１５４を通って遠位に動くと、ナイフを含む駆動ビームはナイフチャネル１３８を通って動く。内視鏡外科手術ステープリング器具のさらなる詳細は、Ｍｉｌｌｉｍａｎらへの同一出願人所有の米国特許第６，９５３，１３９号に詳細に説明され、この特許の内容全体が本明細書によって本明細書に参照によって援用される。しかしながら、クランプバー（図示されていない）をスライドさせることを含む、ジョー部材を接近させる他の方法もまた使用可能であることもまた想定される。カムバーなど、ファスナーを射出する他の方法が企図される。
図３および図４を参照すると、組織停止部１７０は、ジョー部材１３０の遠位部分に規定される凹部１６４内に少なくとも部分的に可動に配置される。用語「遠位」は、典型的にはユーザからより遠くに離れている、器具の部分または構成要素をいう。本明細書において用いられる場合、用語「遠位」および「近位」は、本開示の外科手術器具の湾曲した部分の湾曲を考慮に入れる。例えば、「遠位」は、湾曲した部分によって規定される軌道に沿って、ユーザから最も遠い湾曲した部分の一部分をいう。すなわち、使用中、湾曲した部分の中間部分はユーザからより遠くにあり得るが、長手方向軸に沿って最も遠い湾曲した部分の一部分は「遠位」として考えられる。
ジョー部材１３０の遠位部分は、凹部１６４を規定し、近位壁１６５と、一対の側壁１６６、１６８と、下部表面１６９とを含む。組織停止部１７０は、上部組織接触表面１７４を有する本体１７２と、一対の横壁１７６、１７８と、（例えば、ジョー部材間から遠位に向けられる組織などの）組織を係合するように構成されかつ適合されるストッピング部分１８２とを含む。
近位カミングピン１８４と遠位カミングピン１８６とを含む一対のカミングピンもまた開示される。各カミングピン１８４、１８６は、本体１７２の横壁１７６、１７８の両方を通り横断して延びるように構成される。近位カミングピン１８４は、本体１７２の第１の一対の穴１７７を通って延びるように構成され（１つのみの穴１７７が横壁１７６に示され、横壁１７８を通って配置される穴は図４には見えない）、一対の近位カムスロット１９６を係合するように構成され、一対の近位カムスロット１９６は、少なくとも部分的に凹部１６４の側壁１６６、１６８の各々を通って延びる。遠位カミングピン１８６は、本体１７２の第２の一対の穴１７９を通って延びるように構成され（１つのみの穴１７９が横壁１７６に示され、横壁１７８を通って配置される穴は図４には見えない）、一対の遠位カムスロット１９８を係合するように構成され、一対の遠位カムスロット１９８は、少なくとも部分的に凹部１６４の側壁１６６、１６８の各々を通って延びる。理解され得るように、カミングピン１８４、１８６と、ジョー部材１３０と、組織停止部１７０との間の係合は、組織停止部１７０をジョー部材１３０に可動に固定する。
例示される実施形態において、遠位カムスロット１９８は、ジョー部材１３０の組織接触表面１３４に実質的に平行であり、近位カムスロット１９６は、ジョー部材１３０の組織接触表面１３４に対して角度を形成する、近位カムスロット１９６は、少なくとも１つの湾曲部分、少なくとも１つの直線部分、または少なくとも１つの湾曲部分および少なくとも１つの直線部分の組み合わせを含むことが想定される。カムスロット１９６、１９８の例示される構成は、組織停止部分１８２が、組織停止部分１８２と近位壁１６５との間の減少した隙間「Ｇ」を有する近位壁１６５に隣接する凹部１６４の中にそして凹部１６４から出るように可動であることを可能にする（図５を参照されたい）。組織停止部１７０が第１の位置から第２の位置に動くと、隙間「Ｇ」が刻々最小限にされ得ることもまた想定される。組織停止部をジョーに接続するために他のカム配置が用いられ得る。カムは、組織停止部がジョーから延びるとき（第１の位置）組織停止部の高さを最大にしかつ／または組織停止部が引き込みの第２の位置にあるときジョー内において組織停止部によって占められるスペースを最小にするような形状であり得る。
図５に示されるように、組織停止部１７０はまた付勢部材１７３を含む。付勢部材１７３は、カミングピン１８６を機械的に係合し、ジョー部材１３０の側壁１６６、１６８の各々における開口部１９０（図４を参照されたい）を通って延びるサポートピン１５８を機械的に係合するように構成される。しかしながら、付勢部材１７３の一端を保持するためにポストなどの任意の他の保持部材がサポートピン１５８に取って代わり得ることもまた企図される。付勢部材１７３は、カミングスロット１９８内における最近位位置に遠位カミングピン１８６を推進する。近位に推進される遠位カミングピン１８６に応答して、近位カミングピン１８４もまた、近位カミングピン１８４、１８６と、付勢部材１７３と、組織停止部１７０との間の機械的な関係により近位に推進される。カミングピン１８４がカミングスロット１９６内の最近位位置にあり、カミングピン１８６がカミングスロット１９８内の最近位位置にある場合、組織停止部１７０は、第１の位置に位置を定められ、第１の位置において、停止部分１８２は、露出され、凹部１６４から少なくとも部分的に延び、すなわち、カートリッジ１３２の組織接触表面１３４とアンビルアセンブリ１４２の組織接触表面１３５との間に配置される（例えば、図５を参照されたい）。
組織停止部１７０は、図５に示されるような第１の位置と図８に例示されるような第２の位置との間で可動である。ジョー部材１３０、１４０が開放位置にあるときに対応する第１の位置において、停止部分１８２の（例えば、大部分または全部などの）少なくとも一部分は、凹部１６４から露出している。ジョー部材１３０、１４０の接近は、ジョー部材１３０、１４０の第２の位置の方に組織停止部１７０を動かす。すなわち、（例えば、ジョー部材１４０などの）一つのジョー部材がもう一方の（たとえば、ジョー部材１３０などの）ジョー部材の方に動くと、組織接触表面１３５は、組織停止部１７０の組織接触表面１７４と接触し、付勢部材１７３の付勢に対抗してジョー部材の第２の位置の方に組織停止部１７０を物理的に推進する。ジョー部材１３０、１４０が接近位置にあるときに対応する第２の位置において、停止部分１８２の（例えば、全部などの）大部分は、凹部１６４内に配置される。この実施形態において、組織停止部１７０が第１の位置に配置される場合、停止部分１８２は、組織接触表面１３４に対して（例えば、実質的に垂直であるなど）直交に配置される。理解され得るように、そのような配向は、組織がツールアセンブリ１５０から遠位に脱出するのを妨げることを助け得る。他の実施形態において、器具は、組織停止部に接続されるアクチュエータを含み得、その結果、ユーザは、ボタンまたはレバーを操作することによって第１の位置と第２の位置の間に組織停止部を動かし得る。そのようなアクチュエータはまた、組織停止部の位置のロック、および／または組織停止部の位置をロックする掛金を含み得る。
使用時、外科医は、図６に示されるように、最初に標的組織に隣接して外科手術ステープリング器具１００の位置を決める。ここで、組織停止部１７０は第１の位置にあり、第１の位置において、ジョー部材１３０、１４０は、開放位置にあり、停止部分１８２の少なくとも一部分は凹部１６４から露出している。次いで組織「Ｔ」は、ツールアセンブリ１５０の中のジョー部材１３０と１４０との間に導入される。図６に見られるように、組織停止部１７０の上部組織接触表面１７４によって規定される角度は、概ね矢印「Ｂ」の方向にツールアセンブリ１５０の中に組織「Ｔ」を導入することを容易にする。組織「Ｔ」がツールアセンブリ１５０の中に近位に挿入されると、組織「Ｔ」は、組織停止部１７０と接触するようになり、図７に示されるように、概ね矢印「Ｃ」の方向に停止部分１８２の少なくとも一部分を凹部１６４の中に押し込み得る。特定の実施形態において、組織停止部は、ジョーの開放端部に面する傾斜した表面を有し、組織が組織停止部を動かすことを促進する。あるいは、組織「Ｔ」は、停止部部材１７０に必ずしも接触することなく、ジョー部材１４０の組織接触表面１３５と組織停止部１７０の組織接触表面１７４との間のスペースにおいて動くことによって、ジョー部材１３０と１４０との間に近位に挿入され得る。
第２の位置に動かされると、組織停止部分１８２は、概ね矢印「Ｃ」の方向に動く（図７）。組織停止部分１８２が概ね矢印「Ｃ」の方向に並進させられると、遠位カミングピン１８６は、概ね矢印「Ｅ」の方向に遠位カミングスロット１９８に沿って遠位に並進し（図７）、一方、近位カミングピン１８４は、概ね矢印「Ｄ」の方に近位カミングスロット１８４に沿って遠位にスライドする（図７）。
外科医がジョー部材１３０と１４０との間に組織「Ｔ」の少なくとも一部分を配置した後、図８に示されるように、外科医は、例えば固定ハンドル１１４の方に可動ハンドル１１２を旋回させることによって接近機構を作動させ得、カートリッジアセンブリ１３２の方にアンビルアセンブリ１４２を接近させ、組織接触表面１３４と１３５の間に組織「Ｔ」を捕捉し得る。ここで、組織停止部１７０の組織接触表面１７４の近位部分は、カートリッジアセンブリ１３２の組織接触表面１３４と実質的に同一平面であり、アンビルアセンブリ１４２は、停止部部材１７０に対して（組織「Ｔ」を通って）凹部１６４の方に力を加える。アンビルアセンブリ１４２によって組織停止部１７０に加えられる力に応答して、カミングピン１８６は、カミングピン１８６がカミングスロット１９８の最遠位部分になるまで、概ね矢印「Ｅ」の方向にカミングスロット１９８に沿ってさらに遠位に並進する。さらに、カミングピン１８４は、カミングピン１８４が付勢部材１７３の付勢に対抗してカミングスロット１９６の最遠位部分に到達するまで、概ね矢印「Ｈ」の方向に(図８）カミングスロット１９６に沿ってさらに遠位にスライドする。組織「Ｔ」は、ここでジョー部材１３０と１４０との間に置かれ、外科医によって概ね矢印「Ｆ」の方向に（図７〜図９）さらに近位に押され得る。組織「Ｔ」の遠位端が概ね「Ｆ」の方向に組織停止部１７０の近位に押されると、付勢部材１７３によって加えられる付勢力は、アンビルアセンブリ１４２の組織接触表面１３５の方に（かつおそらくは組織接触表面１３５に対抗して）、概ね矢印「Ｉ」の方向に組織停止部１７０を押す。ここで、組織「Ｔ」の厚さに比例して、カミングピン１８４はカミングスロット１９６に沿って近位に動き、カミングピン１８６はカミングスロット１９８に沿って近位に動く。
図９に例示される実施形態において、組織停止部１７０は、組織接触表面１３５に接触しており、組織「Ｔ」の遠位に位置を定められ、それによって、組織「Ｔ」のどんな遠位への脱出も妨げるかまたは防ぐ。この時点で、外科医は、例えば、組織「Ｔ」をステープルで留め、密封しかつ／または切るなど、組織「Ｔ」に対して外科手術処置を行ない得る。外科手術処置を行なった後、ジョー部材１４０はジョー部材１３０から離れるように動かされ、組織停止部１７０は付勢力に応答してその最初の位置に戻る。
図１０を参照すると、本開示の別の実施形態に従うローディングユニット５００が例示される。ローディングユニット５００は、近位本体部分５５６と、ツールアセンブリ５５０とを含む。近位本体部分５５６は、細長い部分１２０の遠位端に解除可能に取り付け可能である。ツールアセンブリ５５０は、アンビルアセンブリ５４２と、カートリッジアセンブリ５３２とを含む一対のジョー部材を含む。特に、カートリッジアセンブリ５３２はアンビルアセンブリに対して旋回可能であり、開放位置またはクランプ外れ位置と閉鎖位置または接近位置との間で可動である。
アンビルアセンブリ５４２は、長手方向に湾曲したアンビルカバー５４３と、長手方向に湾曲したアンビルプレート５４４とを含み、長手方向に湾曲したアンビルプレート５４４は、複数のステープル形成くぼみ（ｓｔａｐｌｅ ｆｏｒｍｉｎｇ ｄｅｐｒｅｓｓｉｏｎ）を規定する。ツールアセンブリ５５０が接近位置にあるとき、ステープル形成底部はカートリッジアセンブリ５３２と並置した整列で位置を決められる。カートリッジアセンブリ５３２は長手方向に湾曲したキャリア５３７を含み、長手方向に湾曲したキャリア５３７は例えばスナップ嵌め接続などを介して長手方向に湾曲したカートリッジ５１８を受ける。カートリッジ５１８は、キャリア５３７においてカートリッジ５１８を安定させるためにキャリア５３７の側壁５３９に置かれる一対の支柱５１９を含む。キャリア５３７の外部表面は、ある角度に置かれたカム表面５１６ａを含む。
カートリッジ５１８は、複数の横に間隔を空けて配置されたステープル保持スロット５３６を規定する。各スロット５３６は、そこにステープル６３０を受けるように構成される。カートリッジ５１８は、中央の長手方向に湾曲したスロット５３８を含む。作動スレッド５４１がカートリッジ５１８を通って動くと、作動スレッド５４１のカムウェッジ５４１ａは、プッシャ６３２を順次係合し、ステープル保持スロット５３６内に垂直にプッシャ６３２を動かし、アンビルプレート５４４のステープル形成くぼみ（ｓｔａｐｌｅ ｆｏｒｍｉｎｇ ｄｅｐｒｅｓｓｉｏｎ）の中にステープル６３０を射出する。保持スロット５３６からのステープル６３０の射出に続いて、ダイナミッククランピング部材６０６の切断エッジ６０６ａがカートリッジ５１８の湾曲したスロット５３８を通って走行すると、切断エッジ６０６ａは、ステープル留めされた組織を切断する。
引き続き図１０を参照すると、近位本体部分５５６は、成形の片側部５０３ａおよび５０３ｂから形成される内部本体５０３と、駆動アセンブリ５６０とを含む。近位本体部分５５６は、取り付けアセンブリ５７０によってツールアセンブリ５５０に連結される。取り付けアセンブリ５７０は、キャリア５３７の近位端の中に延びる一対の延長部５７６を有する。各延長部５７６は、キャリア５３９の穴５１６Ａに整列している横孔５７８を有し、その結果、取り付けアセンブリ５７０は、キャリア５３９を有するカートリッジ５１８に旋回可能に固定される。取り付けアセンブリ５７０は、一対の垂直突出部５８４によって片側部５０３ａに固定して留められる。垂直突出部５８４は、取り付けアセンブリ５７０から上方に延び、片側部５０３ａにおける対応する凹部に摩擦によって適合する。
アンビルカバー５４３は、フィンガー５８８に形成される一対のカットアウト５８９を有する近位に延びるフィンガー５８８を含む。カットアウト５８９は、フィンガー５８８の各横側面に位置を決められ、片側部５０３ａにアンビルカバーを固定することを助ける。片側部５０３ａは、一対の突出部５０５ａを含むチャネル５０５を含む。アンビルカバーのフィンガー５８８は片側部５０３ａのチャネル５０５を機械的に係合し、その結果、カットアウト５８９は突出部５０５ａと整列させられる。外部スリーブ６０２は、フィンガー５８８およびチャネル５０５を覆う。フィンガー５８８およびチャネル５０５の構成は、アンビルカバー５４３と片側部５０３ａと間の確実な接続を容易にする。さらに、この接続は、結果として、近位本体部分５５６に対して移動不可能な（例えば、旋回不可能な）アンビルアセンブリ５４２をもたらす。
駆動アセンブリ５６０は、３つの積み重ね金属シート６０４ａ〜６０４ｃから組み立てられる可撓性駆動ビーム６０４と、近位係合部分６０８とを含む。駆動ビーム６０４の少なくとも一部分は、ツールアセンブリ５５０の湾曲を通って前進させられるほど十分に可撓性である。駆動ビーム６０４は、ダイナミッククランピング部材６０６に固定される遠位端を有する。ダイナミッククランピング部材６０６は、垂直支柱６０６ｄの遠位面にナイフまたは切断エッジ６０６ａを含む。
ローディングユニット５００は、カートリッジ５１８の遠位部分に規定される凹部７６４内に少なくとも部分的に可動に配置される組織停止部７７０を含む。凹部７６４は、近位壁７６５と、一対の側壁７６６、７６８と、下部表面とによって規定される。組織停止部７７０は、上部組織接触表面を有する本体７７２と、一対の横壁と、組織を係合するように構成され、適合される停止部分７８２とを含む。近位カミングピン７５８および遠位カミングピン７８６は各々、本体７７２の横壁７６６、７６８の両方を通って横断して延びるように構成される。近位カミングピン７５８は、本体７７２の第１のスルーホール７７７を通って延びるように構成され、一対の近位カムスロット７９６を係合するように構成され、一対の近位カムスロット７９６は、側壁７６６、７６８の各々を通って少なくとも部分的に延びる。遠位カミングピン７８６は、本体７７２の第２のスルーホール７７９を通って延びるように構成され、一対の遠位カムスロット７９８を係合するように構成され、一対の遠位カムスロット７９８は、側壁７６６、７６８の各々を通って少なくとも部分的に延びる。７９６、７９８の少なくとも１つが側壁７６６、７６８のうちの１つに規定されるのみであることもまた企図される。
組織停止部７７０はまた、付勢部材７７３を含む。付勢部材７７３は、カミングピン７８６を機械的に係合し、カートリッジアセンブリ５３２の側壁７６６、７６８の各々における開口部７９０（図４を参照されたい）を通って延びるサポートピン７８４を機械的に係合するように構成される。付勢部材７７３は、カミングスロット７９８内の最近位に遠位カミングピン７８６を推進する。遠位カミングピン７８６を近位方向に推進することに応答して、近位カミングピン７５８もまた、カミングピン７５８、７８６と付勢部材７７３と組織停止部７７０との間の機械的な関係により、近位に推進される。カミングピン７５８がカミングスロット７９６内の最近位位置にあり、カミングピン７８６がカミングスロット７９８内の最近位位置にある場合、停止部分７８２は、露出され、凹部７６４から少なくとも部分的に出るように延びる。ローディングユニット５００の動作は、上記に説明されるものと実質的に同様であり、簡潔さの利益ために省略される。
図１１〜図１７を参照すると、本開示の一実施形態に従う組織停止部１０００が例示される。組織停止部１０００は、２つの部分、すなわちプレス加工された金属部１１００およびオーバーモールドのプラスチック部１２００から作られる。プレス加工された金属部１１００は、図１３〜図１７に例示され、プレス加工された金属部１１００を少なくとも部分的に覆うオーバーモールドのプラスチック部１２００は、図１１〜図１２に例示される。組織停止部１０００の複数部品の設計は、金属の強度を提供し、一方、プラスチック射出成形に適した複合形状を可能にする。プレス加工された金属から作られる組織停止部１０００の特定の部分が示されるが、プレス加工された金属部分１１００が全組織停止部１０００の部分より大きいかまたは少ない部分を含み得ることは本発明の範囲内であり、想定される。同様に、オーバーモールドのプラスチック部１２００もまた、例示されるものより大きいかまたは少ない、全組織停止部１０００の部分を含み得る。
組織停止部１０００は、上部組織接触表面１０２０を有する本体１０１０と、一対の横壁１０３０、１０４０と、（例えば、ジョー部材間から遠位に向けられる組織などの）組織を係合するように構成されかつ適合される停止部分１０５０とを含む。組織停止部１０００の停止部分１０５０は、複数の間隔を空けて配置された半円のへこみ（ｉｎｄｅｎｔ）を含むスカロップ部分１０６０を含む。より具体的には、スカロップ部分１０６０は、横壁１０３０、１０４０の各々の近位エッジに配置される。理解され得るように、スカロップ部分１０６０は、組織停止部１０００に対して組織がスライドするのを防ぐことを助けるように構成される。
組織停止部１７０を参照して上記に考察されるように、組織停止部１０００は、カミングピン１８４、１８６と共に使用可能であり、組織停止部１０００はまた、図１１および図１２に示されるように、本体１０１０から横断して延びる旋回突出部１４００を含み得る。旋回突出部１４００は、カートリッジアセンブリの一部分を旋回して係合するように構成され、旋回突出部とカートリッジアセンブリとの間で旋回の動きを可能にする。
さらに、開示される実施形態において、図１〜図１０に関連して説明される外科手術器具１００およびローディングユニット１８０は、プレス加工された／成形された組織停止部１０００を含む。
本開示される外科手術器具の実施形態に対して様々な修正がなされ得ることは理解される。従って、上記の説明は、限定することとして解釈されるべきではなく、単なる実施形態の例証として解釈されるべきである。当業者は、本開示の範囲および精神内において、他の修正を想定する。
１００ 外科手術器具
１１０ ハンドルアセンブリ
１１２ 可動ハンドル
１１４ 固定ハンドル
１３０ 第１のジョー部材
１３２ カートリッジアセンブリ
１３４ 組織接触表面
１３６ ファスナー保持スロット
１４０ 第２のジョー部材
１４２ アンビルアセンブリ
１５０ ツールアセンブリ
１１０ ハンドルアセンブリ
１１２ 可動ハンドル
１１４ 固定ハンドル
１３０ 第１のジョー部材
１３２ カートリッジアセンブリ
１３４ 組織接触表面
１３６ ファスナー保持スロット
１４０ 第２のジョー部材
１４２ アンビルアセンブリ
１５０ ツールアセンブリ
Claims (17)
- 組織を外科的に接合する外科手術器具であって、該外科手術器具は、
可動ハンドルを含むハンドルアセンブリと、
該ハンドルアセンブリから遠位に延びている細長い部分であって、長手方向軸を規定する細長い部分と、
該細長い部分に動作可能に結合され、該細長い部分から遠位に延びている一対の向かい合うジョー部材であって、該一対の向かい合うジョー部材は、第１のジョー部材と第２のジョー部材とを含む、一対の向かい合うジョー部材と、
該第１のジョー部材に機械的に係合されている組織停止部であって、該組織停止部の少なくとも一部分は、該第１のジョー部材の軸に沿って長手方向に可動であり、該組織停止部は、該一対の向かい合うジョー部材間に組織を保持するように構成されており、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部は、金属部とプラスチック部とを含み、該プラスチック部は、該金属部の一部分を覆うように構成されている、組織停止部と
を備えている、外科手術器具。 - 前記組織停止部の前記停止部分は、スカロップ部分を含む、請求項１に記載の外科手術器具。
- 前記組織停止部の前記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、請求項２に記載の外科手術器具。
- 前記組織停止部は、一対の横壁を含む、請求項１に記載の外科手術器具。
- 前記停止部分は、各横壁の近位エッジに配置されている、請求項４に記載の外科手術器具。
- 前記停止部分は、スカロップ部分を含む、請求項５に記載の外科手術器具。
- 外科手術器具を解除可能に係合するように構成されたローディングユニットであって、該ローディングユニットは、
長手方向軸を規定する本体部分であって、該本体部分は、該外科手術器具の細長い部分を解除可能に係合するように構成された近位部分を含む、本体部分と、
該本体部分から遠位に延びている一対のジョー部材であって、該ジョー部材の少なくとも１つは、開放位置と該ジョー部材間に体組織を係合する接近位置との間で他方に対して可動であり、該一対のジョー部材は、第１のジョー部材と第２のジョー部材とを含む、一対のジョー部材と、
該第１のジョー部材に機械的に係合されている組織停止部であって、該組織停止部の少なくとも一部分は、該第１のジョー部材の軸に沿って長手方向に可動であり、該組織停止部は、該一対の向かい合うジョー部材間に組織を保持するように構成されており、該組織停止部は、該組織停止部の停止部分が該第１のジョー部材の組織接触表面と該第２のジョー部材の組織接触表面との間に配置される第１の位置と、該停止部分が該第１のジョー部材の該組織接触表面と該第１のジョー部材の下部表面との間にある第２の位置との間で可動であり、該組織停止部は、金属部とプラスチック部とを含み、該プラスチック部は、該金属部の一部分を覆うように構成されている、組織停止部と
を備えている、ローディングユニット。 - 前記組織停止部の前記停止部分は、スカロップ部分を含む、請求項７に記載のローディングユニット。
- 前記組織停止部の前記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、請求項８に記載のローディングユニット。
- 前記組織停止部は、一対の横壁を含む、請求項７に記載のローディングユニット。
- 前記停止部分は、各横壁の近位エッジに配置されている、請求項１０に記載のローディングユニット。
- 前記停止部分は、スカロップ部分を含む、請求項１１に記載のローディングユニット。
- 外科手術器具と共に用いられる組織停止部であって、該組織停止部は、
金属部分と、
該金属部分の一部分を覆うように構成されているプラスチック部分と
を備え、
該組織停止部は、該外科手術器具のジョー部材に機械的に係合されており、該組織停止部の少なくとも一部分は、該ジョー部材の軸に沿って長手方向に可動であり、該組織停止部は、該外科手術器具の向かい合うジョー部材間に組織を保持するように構成されている、組織停止部。 - 前記組織停止部は、一対の横壁を含む、請求項１３に記載の組織停止部。
- 停止部分は、各横壁の近位エッジに配置されている、請求項１４に記載の組織停止部。
- 前記停止部分は、スカロップ部分を含む、請求項１５に記載の組織停止部。
- 前記組織停止部の前記スカロップ部分は、複数の間隔を空けて配置された半円のへこみを含む、請求項１６に記載の組織停止部。
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| US (4) | US8899461B2 (ja) |
| EP (1) | EP2436319B1 (ja) |
| JP (2) | JP5944638B2 (ja) |
| CN (1) | CN102440814B (ja) |
| AU (1) | AU2011218637B2 (ja) |
| CA (1) | CA2749735C (ja) |
| ES (1) | ES2778923T3 (ja) |
Families Citing this family (599)
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2011
- 2011-08-12 US US13/208,447 patent/US8899461B2/en active Active
- 2011-08-22 CA CA2749735A patent/CA2749735C/en not_active Expired - Fee Related
- 2011-08-29 AU AU2011218637A patent/AU2011218637B2/en not_active Ceased
- 2011-09-05 JP JP2011192771A patent/JP5944638B2/ja active Active
- 2011-09-09 CN CN201110274276.5A patent/CN102440814B/zh not_active Expired - Fee Related
- 2011-09-09 ES ES11250785T patent/ES2778923T3/es active Active
- 2011-09-09 EP EP11250785.0A patent/EP2436319B1/en active Active
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2014
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|---|---|
| ES2778923T3 (es) | 2020-08-12 |
| CA2749735A1 (en) | 2012-04-01 |
| CA2749735C (en) | 2019-04-02 |
| EP2436319A3 (en) | 2013-09-04 |
| AU2011218637A1 (en) | 2012-04-19 |
| US10499910B2 (en) | 2019-12-10 |
| EP2436319B1 (en) | 2020-02-12 |
| EP2436319A2 (en) | 2012-04-04 |
| US20120080474A1 (en) | 2012-04-05 |
| JP2012075868A (ja) | 2012-04-19 |
| US20150008247A1 (en) | 2015-01-08 |
| US20180140298A1 (en) | 2018-05-24 |
| AU2011218637B2 (en) | 2015-03-19 |
| US9901339B2 (en) | 2018-02-27 |
| US8899461B2 (en) | 2014-12-02 |
| CN102440814A (zh) | 2012-05-09 |
| US20200100784A1 (en) | 2020-04-02 |
| CN102440814B (zh) | 2015-09-30 |
| JP2015231557A (ja) | 2015-12-24 |
| US11375998B2 (en) | 2022-07-05 |
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