JP6174103B2 - 独立型グリッパ - Google Patents
独立型グリッパ Download PDFInfo
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- JP6174103B2 JP6174103B2 JP2015230051A JP2015230051A JP6174103B2 JP 6174103 B2 JP6174103 B2 JP 6174103B2 JP 2015230051 A JP2015230051 A JP 2015230051A JP 2015230051 A JP2015230051 A JP 2015230051A JP 6174103 B2 JP6174103 B2 JP 6174103B2
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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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
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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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/246—Devices for obstructing a leak through a native valve in a closed condition
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2463—Implants forming part of the valve leaflets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2475—Venous valves
-
- 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
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
収縮器における正常な心臓Hの左心室LVが図1に示されている。左心室LVは、収縮中であり、血液は、矢印の方向に三尖弁(大動脈弁)を通って外方に流れている。血液の逆流又は僧帽弁MVの「閉鎖不全」は、僧帽弁が「逆止弁」として構成されているので阻止され、逆止弁は、左心室内の圧力が左心房LA内の圧力よりも高いときの逆流を阻止する。僧帽弁MVは、図1に示されているように閉じるよう均等に出会う自由縁FEを備えた1対の小葉を有する。小葉LFの互いに反対側の端は、弁輪ANと呼ばれる環状領域に沿って周囲の心臓構造体に取り付けられている。小葉LFの自由縁FEは、腱索CT(以下、索という)を介して左心室LVの下側部分に固定され、索CTは、弁小葉LFの各々の下面上に固定された複数の枝分かれ腱を含む。索CTは、乳頭筋PMに取り付けられ、乳頭筋PMは、左心室の下側部分及び心室中隔IVSから上方に延びている。
本発明の観点によれば、例えば弁小葉のような組織を把持し、近置し、固定して心臓弁閉鎖不全、特に僧帽弁閉鎖不全を治療する方法及び器具が提供される。本発明は又、特に抜去が解剖学的特徴、例えば索CTによって妨げられる場合のある野において所望ならば器具の再位置決め及び抜去を可能にする特徴を提供する。かかる抜去により外科医は、望ましい場合に新たな仕方で弁に再接近することができる。
A.導入及び配置
固定器具14は、デリバリ器具の使用により弁又は所望の組織に送られる。デリバリ器具は、用途に応じて剛性であっても良く可撓性であっても良い。血管内用途に関し、デリバリ器具は、後の段落で説明する柔軟性デリバリカテーテルから成る。しかしながら、代表的には、かかるカテーテルは、近位端部及び遠位端部を備えたシャフトを有し、固定器具は、その遠位端部に解除可能に取り付けられる。シャフトは、通常、細長く且つ可撓性であり、血管内導入に適している。変形例として、デリバリ器具は、心臓の壁を通る経胸的外科的導入に使用できる短く且つ可撓性の低いインターベンション器具から成っていても良い。ただし、一般的に、或る程度の可撓性があること及びプロフィールが最小限であることが望ましい。固定器具は、図3Aに示されているようにデリバリ器具に解除可能に結合できる。固定器具は、種々の形態を取ることができ、固定器具のほんの少しの実施形態について本明細書において説明する。
上述したように、固定器具14は、オプションとして、器具14を特定の位置、例えば開き位置、閉じ位置若しくは反転位置又はこれら相互間の任意の位置にロックするロック機構体を有する。理解できるように、ロック機構体は、固定器具をロックしたりロック解除したりすることができるロック解除機構体を含む。図18〜図21は、ロック機構体106の実施形態を示している。図18を参照すると、この実施形態では、ロック機構体106は、結合部材19と作動機構体58のベース69との間に設けられている。ベース69は、スタッド74にしっかりと取り付けられており、スタッド74は、ロック機構体106を貫通して延びている。スタッド74は、アクチュエータロッド64に解除可能に取り付けられ、アクチュエータロッド64は、インターベンションツール10の結合部材19及びシャフト12を貫通して延びている。ベース69も又、作動機構体58の脚部68に連結され、脚部68は、遠位要素18に連結されている。
別の実施形態では、図9を参照すると、近位要素16の作動は、1つ又は2つ以上の近位要素ライン又はアクチュエータ90を用いることによって達成できる。かかる作動は、種々の仕方で達成できる。例えば、図22Aに示されているように、近位要素アクチュエータ90A及び90Bをラインループ48A,48B中に通すのが良く、ラインループは、それぞれ、近位要素16A,16Bの半径方向外方の側部及び近位側の側部に設けられている。近位要素アクチュエータ90A,90Bの遠位端部は、閉鎖ループ95A,95Bを有するのが良く、これら閉鎖ループは、図22Aに示されている互いに結合されたシャフト12と結合部材19を包囲している。上述したように、シャフト12と結合部材19を互いに解除可能に結合することができる。閉鎖ループ95A,95Bがシャフト12及び結合部材19を包囲するようにするために、シャフト12と結合部材19の結合に先立って閉鎖ループ95A,95Bをシャフト12及び/又は結合部材19に嵌める。閉鎖ループ95A,95Bがシャフト12及び結合部材19を包囲すると、閉鎖ループ95A,95Bは、近位要素アクチュエータ90A,90Bの遠位端部をシャフト12及び結合部材19に対して定位置に保持し、近位要素アクチュエータ90A,90Bを引っ込めることができる程度を制限する。近位要素アクチュエータ90A,90Bをラインループ48A,48Bに通すことによってそれぞれ近位要素16A,16Bに機械的に連接する。かくして、図23に示されているように、近位要素アクチュエータ90A,90Bを方向96に近位側に引っ込めると、これら近位要素アクチュエータは、近位要素16A,16Bをそれぞれ遠位要素18A,18Bから遠ざける。同様に、近位要素アクチュエータ90A,90Bを遠位側に押すことにより、近位要素16A,16Bは、遠位要素18A,18Bに近づく。
他の実施形態では、順次把持を単一アクチュエータの使用によって達成することができる。図34は、近位端部及び遠位端部を備えた単一の近位要素アクチュエータ90がシャフト302のノーズ318から近位要素16Aまで延びている形態を示している。この単一近位要素アクチュエータは、近位要素16Aの遠位端部のところに設けられたアイレットを通ってループ状にされ又は同じ場所で縫合糸によって保持されるのが良い。この近位要素アクチュエータ90は、次に、結合シャフト12を横切って他方の近位要素16Bまで延び、ここで、近位要素アクチュエータ90は、近位要素16Aと同じ仕方でこの近位要素16Bの遠位端部に結合されている。この近位要素アクチュエータ90の遠位端部は、結合シャフト12か結合部材19かのいずれかまで延び、ここで、固定されている。図34では、この近位要素アクチュエータ90の遠位端部は、ループを用いて固定されている。しかしながら、近位要素アクチュエータは、以下に説明する実施形態のうちの任意のものに従って固定器具14に解除可能に固定できる。
幾つかの状況において、弁小葉は、近位要素と遠位要素との間の貧弱な小葉挿入に起因して、固定器具から完全に又は部分的に外れる場合がある。したがって、固定器具内への弁小葉挿入の評価は、標準型画像化技術、例えば心エコー検査法やX線透視法を用いて実施される。しかしながら、デリバリカテーテルに対する近位要素及び遠位要素の角度及び/又は位置に応じて、固定器具内への弁小葉挿入の深さを評価すること又は小葉と固定器具の近位及び遠位要素を区別することが難題となる場合がある。したがって、視覚化は、好ましくは、遠位要素が互いに変位した状態で遠位要素がより開いた形態にある状態で実施される。しかしながら、固定器具の現行の多くの実施形態は、近位要素を約85°の夾角まで開くことができるようにするに過ぎないので、遠位要素は、弁小葉を近位要素と遠位要素との間にしっかりと把持するためには約45°〜好ましくは60°の夾角まで閉じられなければならない。この形態は、オペレータが弁小葉と固定器具を視覚化してこれらを区別するのを助けるが、遠位要素を90°を超え、より好ましくは120°以上の夾角まで一段と開くことが好ましい。かくして、近位要素を改造してこれが一段と開くようにすることが好ましい。
上述の実施形態のうちの多くに関し、近位要素アクチュエータ90又は近位要素アクチュエータ90A,90Bは、固定器具14に解除可能に結合可能な端部を有する。上述した実施形態のうちの任意のものに適用可能な近位要素アクチュエータを解除可能に結合する種々の方法及び構造体を示す多数の実施形態について以下において説明する。
上述したように、図39は、好ましくは2本のばねアーム99を有するグリッパ型プッシャ83を強調して示している。各アーム99は、ワイヤで作られ又は他の素材から機械加工により作られ、この実施形態では、長方形の断面を有し、但し、他の断面も又想定される。図39の実施形態では、各アーム99の遠位部分91は、固定器具に設けられたボス又は他の取り付け機構体に係合することができる1対のフィンガを形成した切欠き領域93を有している。切欠きは、固定器具14をデリバリカテーテルシャフト12から取り外したときにボスから解除可能である。図57及び図58は、グリッパ型プッシャ83のアーム99をL字形ロック形態との組み合わせで解除可能に固定する変形実施形態を示している。
Claims (16)
- 組織に係合するための固定システムであって、
植え込み型の固定器具を含み、前記固定器具は、各々が第1の端部、前記第1の端部と反対側の自由端部及び前記第1の端部と前記自由端部との間に位置していて、前記組織に係合する係合面を備えた1対の固定要素を有し、前記第1の端部は、前記固定要素が、前記係合面が互いに向かい合う閉じ位置と前記係合面が互いに遠ざかって位置した第1の開き位置との間で動くことができるよう互いに可動的に結合され、前記固定器具は、前記固定要素に結合されていて、前記固定要素を前記閉じ位置と前記第1の開き位置との間で動かすようになった作動機構体と、第1の把持要素及び第2の把持要素を含む1対の把持要素とを更に有し、前記把持要素の各々は、前記固定要素のうちの一方に対して動くことができると共に前記係合面のうちの一方との間に組織を捕捉するよう前記係合面のうちの一方に対向して動かされるよう構成され、
前記植え込み型器具に解除可能に結合されると共に前記把持要素を個々に作動させるよう構成された第1のグリッパ型アクチュエータを含み、
近位部分及び遠位部分を備えた細長いデリバリシャフトを更に含み、前記遠位部分は、前記植え込み型固定器具の前記近位部分に解除可能に結合され、
前記第1のグリッパ型アクチュエータは、前記デリバリシャフトの前記近位端部から延びるグリッパラインを有し、このグリッパラインは、デリバリシャフトの近位端部と遠位端部との間のグリッパラインの部分のところで前記第1の把持要素及び前記第2の把持要素の各々に結合されると共に前記植え込み型固定器具の前記近位端部又は前記細長いデリバリシャフトの前記遠位端部のうちの少なくとも一方に解除可能に結合されていることを特徴とする固定システム。 - 前記自由端部は、前記係合面が互いに向かい合った閉じ位置と前記係合面が互いに遠ざかる方向に向いた反転位置との間で動くよう互いに可動的に結合されている、請求項1記載の固定システム。
- 前記固定要素は各々、前記把持要素を前記係合面のうちの一方に対向して動かすと、前記1対の把持要素の各々をそれぞれ対応して受け入れる凹状部分を有する、請求項1記載の固定システム。
- 前記第1のグリッパ型アクチュエータは、前記植え込み型固定器具に解除可能に結合されると共に第1の形態と前記第1の把持要素を前記1対の固定要素のうちの第1の固定要素に向かって動かす第2の形態との間で作動可能である、請求項1記載の固定システム。
- 前記第1のグリッパ型アクチュエータは、前記第2の形態と前記第2の把持要素を前記第1の把持要素の前記運動とは無関係に前記1対の固定要素のうちの第2の固定要素に向かって動かす第3の形態との間で作動可能である、請求項4記載の固定システム。
- 前記第1のグリッパ型アクチュエータは、近位端部及び遠位端部を有し、前記遠位端部は、前記植え込み型固定器具の前記近位端部又は前記細長いデリバリシャフトの前記遠位端部のうちの少なくとも一方に解除可能に結合されている、請求項1記載の固定システム。
- 前記グリッパラインは、前記グリッパラインに加わる張力によって作動され、前記グリッパラインは、異なる合力を前記第1の把持要素及び前記第2の把持要素の各々に加えて種々の張力レベルで把持要素の個々の作動を生じさせる、請求項1記載の固定システム。
- 前記第1のグリッパ型アクチュエータは、前記細長いデリバリシャフトが前記植え込み型固定器具から取り外されると、前記植え込み型固定器具から解除される、請求項1記載の固定システム。
- 前記グリッパラインは、前記植え込み型固定器具に解除可能に固定されている、請求項1記載の固定システム。
- 前記第1のグリッパ型アクチュエータは、前記細長いデリバリシャフトが前記植え込み型固定器具から取り外されると、前記植え込み型固定器具から解除される、請求項1記載の固定システム。
- 組織に係合するための固定システムであって、
植え込み型固定器具を含み、前記固定器具は、第1の固定要素及び前記第2の固定要素を含む1対の固定要素を有し、各固定要素は、第1の端部、前記第1の端部と反対側の自由端部及び前記第1の端部と前記自由端部との間に位置していて、前記組織に係合する係合面を有し、前記第1の端部は、前記固定要素が、前記係合面が互いに向かい合う閉じ位置と前記係合面が互いに遠ざかって位置した第1の開き位置との間で動くことができるよう互いに可動的に結合され、前記固定器具は、前記固定要素に結合されていて、前記固定要素を前記閉じ位置と前記第1の開き位置との間で動かすようになった作動機構体と、第1の把持要素及び第2の把持要素を含む1対の把持要素とを更に有し、前記把持要素の各々は、前記固定要素のうちの一方に対して動くことができると共に前記係合面のうちの一方との間に組織を捕捉するよう前記係合面のうちの一方に対向して動かされるよう構成され、
前記植え込み型固定器具に解除可能に結合されていて、前記第1の把持要素を作動させるよう構成された第1のグリッパ型アクチュエータを含み、前記第1のグリッパ型アクチュエータは、第1の形態及び第2の形態を有し、前記第1のグリッパ型アクチュエータを前記第1の形態と前記第2の形態との間で作動させると、前記第1の把持要素が前記第1の固定要素に対して動くものであり、
前記植え込み型固定器具に解除可能に結合されていて、前記第2の把持要素を作動させるよう構成された第2のグリッパ型アクチュエータを含み、前記第2のグリッパ型アクチュエータは、第1の形態及び第2の形態を有し、前記第2のグリッパ型アクチュエータを前記第1の形態と前記第2の形態との間で作動させると、前記第1の把持要素が前記第1の固定要素に対して動くものであり、
近位部分及び遠位部分を備えた細長いデリバリシャフトを更に含み、この細長いデリバリシャフトの前記遠位部分は、前記固定器具の近位部分に解除可能に結合され、
前記第1のグリッパ型アクチュエータは、近位端部及び遠位端部を備えた第1のグリッパラインを有し、前記第2のグリッパ型アクチュエータは、近位端部及び遠位端部を備えた第2のグリッパラインを有し、
前記第1のグリッパライン及び前記第2のグリッパラインの遠位部分は、前記植え込み型固定器具の前記近位端部又は前記細長いデリバリシャフトの前記遠位端部のうちの少なくとも一方に解除可能に結合されていることを特徴とする固定システム。 - 前記第1のグリッパ型アクチュエータ及び前記第2のグリッパ型アクチュエータは、互いに無関係に前記第1の形態と前記第2の形態との間で作動可能である、請求項11記載の固定システム。
- 前記第1のグリッパライン及び前記第2のグリッパラインの前記遠位部分は、前記植え込み型固定器具に解除可能に結合されている、請求項12記載の固定システム。
- 前記第1のグリッパ型アクチュエータ及び前記第2のグリッパ型アクチュエータは、前記植え込み型固定器具に解除可能に固定されている、請求項11記載の固定システム。
- 前記第1のグリッパ型アクチュエータ及び前記第2のグリッパ型アクチュエータは、前記植え込み型固定器具に解除可能に結合されている、請求項11記載の固定システム。
- 前記第1のグリッパ型アクチュエータ及び前記第2のグリッパ型アクチュエータは、前記細長いデリバリシャフトが前記植え込み型固定器具から取り外されると、前記植え込み型固定器具の前記遠位端部又は前記細長いデリバリシャフトの前記遠位端部のうちの前記少なくとも一方から解除される、請求項11記載の固定システム。
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
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JP2017170214A (ja) * | 2011-09-13 | 2017-09-28 | アボット、カーディオバスキュラー、システムズ、インコーポレーテッドAbbott Cardiovascular Systems Inc. | 独立型グリッパ |
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US12029425B2 (en) | 2021-09-22 | 2024-07-09 | Abbott Cardiovascular Systems Inc. | Independent gripper |
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US20220054132A1 (en) | 2022-02-24 |
CN106420113A (zh) | 2017-02-22 |
EP2755573A1 (en) | 2014-07-23 |
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JP5847944B2 (ja) | 2016-01-27 |
WO2013039804A1 (en) | 2013-03-21 |
CN103826548A (zh) | 2014-05-28 |
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CN106420113B (zh) | 2018-09-21 |
EP3656314A1 (en) | 2020-05-27 |
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EP3656314B1 (en) | 2022-08-31 |
EP4115821A1 (en) | 2023-01-11 |
EP3391832A1 (en) | 2018-10-24 |
JP2017170214A (ja) | 2017-09-28 |
JP2014530666A (ja) | 2014-11-20 |
US11141158B2 (en) | 2021-10-12 |
JP6535369B2 (ja) | 2019-06-26 |
EP3391832B1 (en) | 2020-08-05 |
EP2755573B1 (en) | 2018-05-23 |
US9011468B2 (en) | 2015-04-21 |
CN103826548B (zh) | 2016-10-12 |
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