JP6339163B2 - 外科用ステープリング器具のためのアンビル - Google Patents
外科用ステープリング器具のためのアンビル Download PDFInfo
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Description
(1) 外科用ステープリング器具のためのアンビルアセンブリであって、
折り畳まれた向きと展開された向きとの間の選択的運動のために移動可能に一緒に連結される複数のアンビルプレートであって、前記展開された向きにあるとき、ほぼ平面のアンビルプレートアセンブリの少なくとも一部分を形成する、複数のアンビルプレートと、
前記複数のアンビルプレートに対して移動可能に支持され、第1の非作動位置と第2の位置との間で選択的に移動可能であるアンビル展開部材であって、前記複数のアンビルプレートを前記展開された向きに移動させる、アンビル展開部材と、
組織穿通先端部分と、
を含む、アンビルアセンブリ。
(2) 前記複数のアンビルプレートが、
第1の弓状アンビルプレートセグメントと、
前記第1の弓状アンビルプレートセグメントに対して移動するために支持される第2の弓状アンビルプレートセグメントと、
を含む、実施態様1に記載のアンビル。
(3) 前記アンビル展開部材が、前記アンビルプレートアセンブリの一部分を形成する、少なくとも2つのアンビルプレートセクションを有する、実施態様1に記載のアンビル。
(4) 前記アンビル展開部材が、前記ほぼ平面のアンビルプレートアセンブリを形成するように前記第2の位置にあるとき、前記第1及び第2の弓状アンビルプレートセグメントの対面する端部の間に延在する、1対の径方向に対向するアンビルプレートセクションを有する、実施態様2に記載のアンビル。
(5) 前記アンビル展開部材が、前記第1の位置から前記第2の位置へと移動されると、前記アンビルプレートが前記折り畳まれた向きから前記展開された向きへと半径方向に外側に移動するように、前記複数のアンビルプレートに対する軸方向の移動のために支持される、実施態様1に記載のアンビル。
(7) 前記複数のアンビルプレートが、
それぞれが第1のアンビルプレートセグメントを有する複数の第1のアンビル部分と、
それぞれが第2のアンビルプレートセグメントを有する複数の第2のアンビル部分と、
を含み、前記第1及び第2のアンビル部分が互いに移動可能に支持され、したがって、前記アンビル展開部材が前記第1の非作動位置にあるとき、前記第1及び第2のアンビル部分が前記折り畳まれた位置にあり、前記アンビル展開部材が前記第2の位置にあるとき、前記第1及び第2のアンビルプレートセグメントが前記ほぼ平面のアンビルプレートアセンブリを形成するように、前記第1及び第2のアンビル部分が前記展開された位置に保持される、実施態様1に記載のアンビル。
(8) それぞれの前記第2のアンビル部分が2つの隣接する前記第1のアンビル部分の間で移動可能に受容される、実施態様7に記載のアンビル。
(9) それぞれの前記第1のアンビルプレートセグメントがその中に少なくとも1つの第1のステープル形成ポケットを有し、それぞれの前記第2のアンビルプレートセグメントがその中に少なくとも1つの第2のステープル形成ポケットを有する、実施態様7に記載のアンビル。
(10) 前記第1及び第2のアンビル部分が前記展開された位置に保持されるとき、前記第1のアンビルプレートセグメント内の前記第1のステープル形成ポケットが第1のステープル形成ポケットの少なくとも1つの第1の環状構成を形成し、前記第2のステープル形成ポケットが、前記アンビルプレートアセンブリ内に第2のステープル形成ポケットの少なくとも1つの第2の環状構成を形成する、実施態様9に記載のアンビル。
(12) 前記アンビル展開部材が円形ステープリング器具のトロカールを含む、実施態様7に記載のアンビル。
(13) 円形外科用ステープリング装置であって、
内部で複数の外科用ステープルを動作可能に支持するステープルカートリッジと、
上に形成された組織穿通先端を有するトロカールシャフトであって、前記ステープルカートリッジに対して選択的に軸方向に移動可能である、トロカールシャフトと、
前記ステープルカートリッジに対して移動可能に支持される傘様のアンビルアセンブリであって、前記トロカールシャフトによって適用された作動運動の適用に応じて、展開されない向きから展開された向きへ選択的に移動するために互いに対して移動可能に支持される複数のアンビルプレートセグメントであって、前記アンビルアセンブリが前記展開された向きにあるとき、前記ステープルカートリッジに対してほぼ対面関係にある環状アンビルプレートアセンブリを形成する、複数のアンビルプレートセグメントを含む、傘様のアンビルアセンブリと、
を含む、円形外科用ステープリング装置。
(14) 前記外科用ステープルが、少なくとも2つの同心円状に配置された向きで前記ステープルカートリッジ内で動作可能に支持され、それぞれの前記アンビルプレートセグメントが、その中に少なくとも1つのステープル形成ポケットを有し、したがって、前記アンビルアセンブリが前記展開された向きにあるとき、前記ステープル形成ポケットが、前記ステープルカートリッジ内の外科用ステープルの前記少なくとも2つの同心円状に配置された構成にほぼ対応する、ステープル形成ポケットの少なくとも2つの同心円状に整列される構成を前記環状アンビルプレートアセンブリ内に形成する、実施態様13に記載の円形外科用ステープリング装置。
(15) 吻合を形成するための外科手技であって、
折り畳まれた構成と展開された構成との間で選択的に移動可能である、アンビルが取り付けられたステープルカートリッジ端部を有する円形ステープラーを提供することと、
折り畳まれた向きに前記アンビルを方向付けることと、
折り畳まれたアンビルが取り付けられた前記ステープルカートリッジ端部を患者の開口部を通して挿入することと、
アンビルが取り付けられた前記ステープルカートリッジ端部で、前記吻合が中を通って形成される標的組織を穿通することと、
前記標的組織が前記展開されたアンビルと前記ステープルカートリッジ端部との間に位置するように前記アンビルを展開することと、
前記ステープルカートリッジ内で支持される外科用ステープルを駆動して、前記展開されたアンビルとの接触を形成するように前記ステープラーを発射することと、
アンビルが取り付けられた前記ステープルカートリッジ端部を前記患者から取り除くことと、
を含む、外科手技。
前記アンビルを折り畳むことと、
前記ステープルカートリッジ端部及びアンビルを前記患者から取り除くことと、
を含む、実施態様15に記載の外科手技。
(17) 前記挿入することが、折り畳まれたアンビルが取り付けられた前記ステープルカートリッジ端部を前記患者の肛門を通して前記患者の結腸の中に挿入することを含む、実施態様15に記載の外科手技。
(18) 前記挿入することが、
前記患者の腹壁を通る開口部を形成することと、
前記開口部を通してトロカールカニューレを設置することと、
折り畳まれたアンビルが取り付けられた前記ステープルカートリッジ端部を前記トロカールカニューレを通して挿入することと、
を含む、実施態様15に記載の外科手技。
(19) 外科用ステープリング器具のためのアンビルプレートであって、前記アンビルプレートが、移動可能に相互接続され、第1の向きから再構成可能な複数のアンビルプレートセグメントを含み、前記アンビルプレートセグメントが、ユニットとしてカニューレ開口部を通って挿入され、次いで前記カニューレ開口部より大きい直径を有する、ほぼ平面のアンビルプレートアセンブリの形態の第2の向きに再構成され得る、アンビルプレート。
(20) 前記複数のアンビルプレートセグメントが、前記第1の向きと前記第2の向きとの間で構成可能である可撓性リング部材上で支持される、実施態様19に記載のアンビルプレート。
(22) 前記複数のアンビルプレートセグメントが複数のヒンジによって一緒に連結される、実施態様19に記載のアンビルプレート。
(23) 前記複数のアンビルプレートセグメントが、端と端とをつないで前記ヒンジによって連結される、4つの弓状プレートセグメントを含み、前記弓状プレートセグメントが前記第1の向きにあるとき、前記4つの弓状プレートセグメントが、互いの上にほぼ重ねられ得るようになっている、実施態様22に記載のアンビルプレート。
(24) それぞれの前記弓状プレートセグメントが、前記環状プレートが前記ほぼ平面の向きにあるとき、ステープル形成ポケットの外側環状リング及びステープル形成ポケットの内側環状リングを形成するように方向付けられる、ステープル形成ポケットの外側構成及びステープル形成ポケットの内側構成をそれぞれ有し、ステープル形成ポケットの前記内側環状リング内の前記ステープル形成ポケットがステープル形成ポケットの前記外側環状リング内の前記ステープルポケットからずれている、実施態様23に記載のアンビルプレート。
(25) 前記弓状プレートセグメントのそれぞれをネジ止めにより係合する可撓性テザーを更に含み、前記弓状プレートセグメントが、環状プレートアセンブリを形成せずに端と端とをつないで前記カニューレ開口部を通して挿入され、次いで作動運動を前記可撓性テザーに適用することによって前記環状プレートアセンブリを形成するように一緒に引き出され、前記弓状プレートセグメントのうちの1つの弓状プレートセグメントの自由端を引き出して、前記弓状プレートセグメントのうちの別の弓状プレートセグメントの別の自由端と隣接して接触させ、前記環状プレートアセンブリを形成し得るようになっている、実施態様23に記載のアンビルプレート。
(27) それぞれの前記アンビルプレートセグメントが2つの端部を有する弓状プレートセグメントを含み、それぞれの前記端部が、前記複数のアンビルプレートが前記環状アンビルプレートアセンブリを形成するときに、隣接するアンビルプレート上の継手形成物と摺動可能に嵌合するように構成される、取付け継手を有する、実施態様26に記載のアンビルプレート。
(28) それぞれの前記アンビルプレートセグメントが形成面を有し、それぞれの前記取付け継手が前記形成面にほぼ平行である取り付けタブ部分を有する、実施態様19に記載のアンビルプレート。
(29) 外科用ステープリング器具のためのアンビルであって、
環状アンビルプレートアセンブリを形成する、非平面の向きとほぼ平面の向きとの間で選択的に移動するために一緒に移動可能に連結される複数のアンビルプレートと、
前記アンビルプレートアセンブリを前記ほぼ平面の向きに保持するように前記アンビルプレートアセンブリに取り付けるように構成される、アンビル支持部材と、
を含む、アンビル。
(30) 前記複数のアンビルプレートが、前記非平面の向きと前記ほぼ平面の向きとの間で構成可能である可撓性リング部材と連結される、実施態様29に記載のアンビル。
(32) 前記複数のアンビルプレートが、複数のヒンジによって一緒に連結される、実施態様29に記載のアンビル。
(33) 前記複数のアンビルプレートが、端と端とをつないで前記ヒンジによって連結される4つの弓状プレートセグメントを含み、前記弓状プレートセグメントが前記非平面の向きのうちの第1の向きにあるとき、前記4つの弓状プレートセグメントが互いの上にほぼ重ねられることができ、前記弓状プレートセグメントが前記非平面の向きのうちの別の向きにあるとき、前記弓状プレートセグメントのうちの2つが前記弓状プレートセグメントのうちの別の2つの上に重ねられるようになっている、実施態様32に記載のアンビル。
(34) それぞれの前記弓状プレートセグメントが、前記環状プレートアセンブリが前記ほぼ平面の向きにあるとき、ステープル形成ポケットの外側環状リング及びステープル形成ポケットの内側環状リングを形成するように方向付けられる、ステープル形成ポケットの外側構成及びステープル形成ポケットの内側構成をそれぞれ有し、ステープル形成ポケットの前記内側環状リング内の前記ステープル形成ポケットが、ステープル形成ポケットの前記外側環状リング内の前記ステープルポケットからずれている、実施態様33に記載のアンビル。
(35) 前記弓状プレートセグメントのそれぞれをネジ止めにより係合する可撓性テザーを更に含み、前記弓状プレートセグメントが、環状プレートアセンブリを形成せずに端と端とをつないで開口部を通して挿入され、次いで、作動運動を前記可撓性テザーに適用することによって前記環状プレートアセンブリを形成するように一緒に引き出され、前記弓状プレートセグメントのうちの1つの弓状プレートセグメントの自由端を引き出して、前記弓状プレートセグメントのうちの別の弓状プレートセグメントの別の自由端と隣接して接触させ、前記環状プレートアセンブリを形成できるようになっている、実施態様33に記載のアンビル。
(37) それぞれの前記アンビルプレートが2つの端部を有する弓状プレートセグメントを含み、それぞれの前記端部が、前記複数のアンビルプレートが前記環状アンビルプレートアセンブリを形成するときに、隣接するアンビルプレート上の継手形成物と摺動可能に嵌合するように構成される取付け継手を有する、実施態様36に記載のアンビル。
(38) それぞれの前記アンビルプレートが形成面を有し、それぞれの前記取付け継手が前記形成面にほぼ平行である取り付けタブ部分を有する、実施態様37に記載のアンビル。
(39) 外科用ステープリング器具のためのアンビルであって、
上にステープル形成面を有するアンビルプレートアセンブリと、
折り畳まれた位置と展開された位置との間で移動するように構成されるアンビル支持部材であって、前記展開された位置にあるとき、前記アンビルプレートアセンブリに取り付け可能であり、前記外科用ステープリング器具の作動装置部分に連結可能である、アンビル支持部材と、
を含む、アンビル。
(40) 前記アンビル支持部材が、
外科用ステープリング装置の作動部材と動作可能に係合するように構成されるシャフトと、
前記シャフト上に移動可能に軸支され、前記シャフト上で前記折り畳まれた位置と前記展開された位置との間で移動可能であるリンケージアセンブリであって、前記アンビルプレートアセンブリに取り付けるように構成される、リンケージアセンブリと、
を含む、実施態様39に記載のアンビル。
(42) それぞれの前記接合リンクが、
前記シャフトの遠位端部分に旋回式に連結される遠位端、及び近位端を有する遠位リンクと、
前記遠位リンクの前記近位端に旋回式に連結される遠位端と、前記シャフト上での軸方向移動のために前記シャフト上に移動可能に軸支されたロックリングに連結される近位端と、を有する近位リンクと、
前記シャフトの前記遠位端と取付け端部との間で前記シャフトに取り付けられる保持つばであって、前記リンケージアセンブリが前記展開された位置にあるとき、前記ロックリングに保持的に係合するように構成される、保持つばと、
を含む、実施態様41に記載のアンビル。
(43) 前記シャフトの前記取付け端部が外科用円形ステープリング器具のトロカールシャフトを動作可能に係合するように構成される、実施態様42に記載のアンビル。
(44) 前記アンビル支持部材が、
外科用ステープリング装置の作動部材と動作可能に係合するように構成されるシャフトと、
前記シャフトの遠位端に旋回式に連結された複数のアームであって、前記アームが前記シャフトとほぼ同一の広がりを持つ前記折り畳まれた位置と、前記アームが前記シャフトから横方向に外側に突出する前記展開された位置との間で移動可能であり、それぞれの前記アームが前記アンビルプレートアセンブリを保持的に係合するように構成された取付け端部を有する、複数のアームと、
を含む、実施態様39に記載のアンビル。
(45) 前記アンビル支持部材が、
遠位端部分及び外科用ステープリング装置の作動部材と動作可能に係合するように構成される近位取付け部分を有する、シャフトアセンブリと、
それぞれが前記アンビルプレートアセンブリを保持的に係合するように構成されたプレート取付け端部を有する複数のアームであって、前記シャフトアセンブリに旋回式に連結され、それぞれの前記プレート取付け端部が前記シャフトアセンブリに隣接する前記折り畳まれた位置と、それぞれの前記プレート取付け端部が前記シャフトアセンブリから離間される前記展開された位置との間で選択的に移動可能である、複数のアームと、
を含む、実施態様39に記載のアンビル。
(47) 前記シャフトアセンブリが、シャフト軸線を画定し、前記複数のアームが、
前記シャフト軸線をほぼ横断する第1の旋回軸線に沿って前記シャフトアセンブリに旋回式に連結される、第1の対の径方向に対向するアームと、
前記シャフト軸線及び前記第1の旋回軸線をほぼ横断する第2の旋回軸線に沿って前記シャフトアセンブリに旋回式に連結される、第2の対の径方向に対向するアームと、
を含む、実施態様45に記載のアンビル。
(48) 前記複数のアームを前記展開された位置に取り外し可能に保持するための手段を更に含む、実施態様47に記載のアンビル。
(49) 取り外し可能に保持するための前記手段が、前記アームが前記展開された位置にあるときに、前記シャフトアセンブリの遠位端に連結され、それぞれの前記アームの近位端を保持的に係合するように構成される、遠位のロック端を含む、実施態様48に記載のアンビル。
(50) 前記シャフトアセンブリが、
遠位端及び外科用円形ステープリング器具のトロカールに取り付けるための取付け端部を有するシャフトであって、前記複数のアームに旋回式に連結される、シャフトと、
前記シャフトの前記遠位端に取り付けられるロックキャップであって、それぞれの前記アームの遠位端を保持的に係合するように構成される、ロックキャップと、
前記シャフトの前記遠位端で支持される変形可能なロック部材と、
前記シャフト上に軸支されるロッキングスリーブであって、前記シャフトがそれに対して移動し得るようになっており、前記シャフトが前記変形可能なロック部材に前記アームの前記近位端を付勢させて前記ロックキャップに保持的に係合させるように近位の方向に移動するときに、前記変形可能なロック部材と選択的に接触するための遠位端を有する、ロッキングスリーブと、
を含む、実施態様46に記載のアンビル。
(52) 外科用ステープリング装置のためのアンビル支持部材であって、前記アンビルが、
前記外科用ステープリング装置の作動装置部分に取り付けるように構成されるシャフトと、
前記シャフトに連結される再構成可能なリンケージアセンブリであって、カニューレ開口部を通して挿入され得る第1の構成から、アンビルプレートアセンブリを支持するように適合される第2の展開された構成へと再構成可能である、リンケージアセンブリと、
を含む、アンビル支持部材。
(53) 外科用ステープリング器具のためのアンビルであって、
前記外科用ステープリング装置の作動装置部分に取り付けるように構成されるアンビルシャフトであって、シャフト軸線を画定する、アンビルシャフトと、
前記アンビルシャフトに連結される再構成可能なアンビルヘッドアセンブリであって、前記シャフト軸線にほぼ垂直である軸線に沿って測定される全体的幅を有し、前記全体的幅が第1の大きさを有する第1の向きと前記全体的幅が前記第1の大きさより大きい第2の大きさを有する第2の向きとの間で再構成可能である、アンビルヘッドと、
を含む、アンビル。
(54) 前記再構成可能なアンビルヘッドアセンブリが、
前記アンビルシャフトに取り付けられ、中心に配設されたアンビル本体と、
前記アンビル本体の第1の対向する端部に取り付けられ、前記端部に相対的に移動可能である、1対の第1のアンビルセグメントであって、前記第1のアンビルセグメントが前記第1の向きにあるときに前記第1のアンビルセグメントの第1の最も外側の縁部の間で測定される第1の幅の大きさが、前記第1のアンビルセグメントが前記第2の向きにあるときの前記第1の幅の前記別の大きさ未満であるようになっている、1対の第1のアンビルセグメントと、
前記アンビル本体の第2の対向する端部に取り付けられ、前記端部に相対的に移動可能である、第2の1対のアンビルセグメントであって、前記第2のアンビルセグメントが前記第1の向きにあるときに前記第2のアンビルセグメントの第2の最も外側の縁部の間で測定される第2の幅の大きさが、前記第2のアンビルセグメントが前記第2の向きにあるときの前記第2の幅の大きさ未満であるようになっている、第2の1対のアンビルセグメントと、
を含む、実施態様53に記載のアンビル。
(55) 前記第1のアンビルセグメントが、前記第1の向きから前記第2の向きに移動するとき、第1の方向に移動し、前記第2のアンビルセグメントが、前記第2のアンビルセグメントが前記第1の向きから前記第2の向きに移動するとき、前記第1の方向と反対の第2の方向に移動する、実施態様54に記載のアンビル。
(57) 前記ステープル発射プラットホームがその上にステープル形成面を有する、実施態様56に記載のアンビル。
(58) 円形ステープリング器具のためのアンビルアセンブリであって、
上にステープル形成面を有する環状アンビルプレートアセンブリと、
前記外科用ステープリング器具の作動装置部分に連結可能であり、折り畳まれた位置と展開された位置との間で選択的に移動するように構成される、アンビル支持部材と、
前記アンビル支持部材が前記外科用ステープリング器具の前記作動装置に連結されるとき、前記環状アンビルプレートアセンブリの前記ステープル形成面が前記円形ステープリング器具内で支持される対応するステープルと実質的に位置合わせされるように、前記アンビル支持部材が前記展開された位置にあるときに、前記アンビル支持部材を前記アンビルプレートアセンブリに連結するための手段と、
を含む、アンビルアセンブリ。
(59) 連結するための前記手段が前記環状アンビルプレートアセンブリ内に複数の孔を含み、前記アンビル支持部材の一部分が、前記複数の孔と係合するために前記複数の孔に対して寸法決めされ、したがって1つの前記一部分が対応する1つの前記孔を保持的に係合するようにのみ構成される、実施態様58に記載のアンビルアセンブリ。
(60) 前記アンビル支持部材が、前記アンビルプレートアセンブリの対応する部分を保持的に係合するように構成された近位端をそれぞれが有する複数の移動可能に支持されたリンケージバーを含む、展開及び折り畳み式のリンケージアセンブリを含む、実施態様58に記載のアンビルアセンブリ。
(62) それぞれの前記リンケージバーの前記近位端が、前記アンビルプレートアセンブリ内の対応するスナッピング空洞に保持的に係合するように構成された少なくとも1つの取付け戻り止めを有する、実施態様60に記載のアンビルアセンブリ。
(63) それぞれの前記近位端が、それに取り付けられ、前記アンビルプレートアセンブリ上の対応する磁石と磁気的に係合するように構成された磁石を有する、実施態様60に記載のアンビルアセンブリ。
(64) 第1の対の径方向に対向する前記リンケージバーの前記近位端の前記磁石が、類似の第1の極を有し、第2の対の径方向に対向する前記リンケージバーの前記近位端の前記磁石が、前記第1の極と異なる類似の第2の極を有する、実施態様63に記載のアンビルアセンブリ。
(65) 前記アンビルプレートアセンブリが、折り畳まれた向きと展開された向きとの間で構成可能であり、前記アンビルプレートアセンブリが前記展開された向きにあるときに前記リンケージアセンブリが、前記アンビルプレートアセンブリに連結可能である、実施態様58に記載のアンビルアセンブリ。
(67) 円形ステープリング器具であって、
複数の外科用ステープルを中に支持するステープリングヘッドと、
発射運動を前記ステープリングヘッドに適用することにより前記ステープリングヘッドから前記外科用ステープルを駆動するために、前記ステープリングヘッドと動作可能に連通する発射システムと、
アンビル調整システムと、
アンビルアセンブリであって、
所定の向きで前記アンビル調整システムに取り付けられるように構成されたアンビルシャフトと、
前記アンビルシャフトに動作可能に連結され、折り畳まれた位置と展開された位置との間で選択的に移動されるように構成されたアンビル支持部材と、
上にステープル形成面を有するアンビルプレートアセンブリと、
前記アンビルシャフトが前記所定の向きで前記アンビル調整システムに連結されるとき、前記アンビルプレートアセンブリの前記ステープル形成面が前記ステープリングヘッド内の対応する前記外科用ステープルと実質的に位置合わせされるように、前記アンビル支持部材が前記展開された位置にあるとき、前記アンビル支持部材を前記アンビルプレートアセンブリに連結するための手段と、
を含む、アンビルアセンブリと、
を含む、円形ステープリング器具。
(68) 前記連結するための手段が、前記アンビルプレートアセンブリ内の複数の孔を含み、前記アンビル支持部材の一部分が、保持的に係合するために前記複数の孔に対して寸法決めされる、実施態様67に記載の円形ステープリング器具。
(69) 前記アンビル支持部材が、前記アンビルプレートアセンブリの対応する部分を保持的に係合するように構成される近位端をそれぞれが有する複数の移動可能に支持されるリンケージバーを含む、展開及び折り畳み式のリンケージアセンブリを含む、実施態様67に記載の円形ステープリング器具。
(70) それぞれの前記リンケージバーの前記近位端が、その上に形成され、前記アンビルプレートアセンブリの対応する部分を保持的に係合するように構成された保持タブを有する、実施態様69に記載の円形ステープリング器具。
(72) それぞれの前記近位端が、それに取り付けられ、前記アンビルプレートアセンブリ上の対応する磁石と磁気的に係合するように構成された磁石を有する、実施態様69に記載の円形ステープリング器具。
(73) 第1の対の径方向に対向する前記リンケージバーの前記近位端上の前記磁石が、類似の第1の極を有し、第2の対の径方向に対向する前記リンケージバーの前記近位端上の前記磁石が、前記第1の極と異なる類似の第2の極を有する、実施態様72に記載の円形ステープリング器具。
(74) 前記アンビルプレートアセンブリが、折り畳まれた向きと展開された向きとの間で構成可能であり、前記アンビルプレートアセンブリが、前記展開された向きのとき、前記アンビル支持部材が、前記アンビルプレートアセンブリに連結可能である、実施態様67に記載の円形ステープリング器具。
(75) 前記アンビル支持部材が、
前記アンビルシャフトによって画定されるシャフト軸線をほぼ横断する第1の旋回軸線に沿って前記アンビルシャフトに旋回式に連結された第1の対の径方向に対向する第1のアームと、
前記シャフト軸線及び前記第1の旋回軸線をほぼ横断する第2の旋回軸線に沿って前記アンビルシャフトに旋回式に連結された第2の対の径方向に対向する第2のアームと、
を含み、連結するための前記手段が、
前記第1のアームのそれぞれに取り付けられ、前記アンビルプレートアセンブリ上の対応する第2の磁石と磁気的に係合するように構成される第1の磁石と、
前記第2のアームのそれぞれに取り付けられ、前記アンビルプレートアセンブリ上の対応する他の前記第1の磁石と磁気的に係合するように構成された別の第2の磁石と、
を含む、実施態様67に記載の円形ステープリング器具。
円形ステープリング器具を提供することであって、
複数の外科用ステープルを中に支持するステープリングヘッドと、
発射運動を前記ステープリングヘッドに適用することにより前記ステープリングヘッドから前記外科用ステープルを駆動するために、前記ステープリングヘッドと動作可能に連通する発射システムと、
アンビル調整システムと、
を含む、円形ステープリング器具を提供することと、
折り畳まれた向きと展開された向きとの間で選択的に移動可能である、アンビル支持部材を提供することと、
ステープル形成面を上に有するアンビルプレートアセンブリを提供することと、
前記アンビル調整システムが、前記折り畳まれた向きにあるとき、前記アンビル支持部材を前記アンビル調整システムに連結することと、
前記ステープリングヘッド及び取り付けられた折り畳まれたアンビル調整システムを患者の開口部を通して挿入することと、
前記開口部又は前記患者の別の開口部を通して前記アンビルプレートアセンブリを挿入することと、
前記アンビル支持部材を前記展開された向きに方向付けることと、
前記アンビルプレートアセンブリ上の前記ステープル形成面が前記ステープリングヘッド内の前記外科用ステープルとほぼ位置合わせをし、ステープル留めされる前記組織が前記ステープル形成面と前記ステープリングヘッドとの間に位置付けられるように、前記アンビルプレートアセンブリを、前記展開されたアンビル支持部材に取り付けることと、
前記外科用ステープルを駆動し、前記ステープル形成面との接触を形成するように前記発射システムを起動することと、
を含む、方法。
(77) 前記アンビル支持部材が、前記連結することの前に前記患者の前記開口部又は前記別の開口部を通して挿入される、実施態様76に記載の方法。
Claims (2)
- 外科用ステープリング器具のためのアンビルであって、
遠位および近位方向に対し垂直方向における全体幅が比較的小さい第1の構成、及び、前記全体幅が比較的大きい第2の構成間で変形可能なアンビルヘッドアセンブリを含み、
前記アンビルヘッドアセンブリは、アンビル本体部分、及び、前記アンビル本体部分に対して移動可能な複数のアンビルプレートを含み、
前記複数のアンビルプレートは、第1のアンビルプレート、及び、第2のアンビルプレートを含み、
前記アンビルヘッドアセンブリが前記第2の構成にある際に、前記第1のアンビルプレート、及び、前記第2のアンビルプレートは、前記アンビル本体部分に対し、前記遠位および近位方向において、略同一の位置にあり、
前記第1のアンビルプレートが、前記アンビル本体部分に対して遠位側に移動し、前記第2のアンビルプレートが、前記アンビル本体部分に対して近位側に移動することによって、前記アンビルヘッドアセンブリが前記第2の構成から前記第1の構成に変形する、アンビル。 - 前記アンビルヘッドアセンブリが前記第2の構成にある際に、前記アンビルヘッドアセンブリは、前記アンビルヘッドアセンブリの近位端から遠位端に向かって、先細りの形状を有している、請求項1に記載のアンビル。
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