JP6353574B2 - コンプライアントな組織ファスナのための送達装置および方法 - Google Patents
コンプライアントな組織ファスナのための送達装置および方法 Download PDFInfo
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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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
-
- 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
-
- 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
- A61B2017/07228—Arrangement of the staples
Description
本明細書は、例えば、以下の項目も提供する。
(項目1)
閉鎖装置と使用するための閉鎖装置アプリケータであって、該閉鎖装置は、対向する組織係合表面を有する2つの脚を有する圧縮体と、該表面の間で展開可能な複数の組織貫通ファスナとを含み、
該アプリケータは、
シャフトと、
該シャフトの近位端に取り付けられたハンドルであって、第1のトリガおよび第2のトリガを有するハンドルと、
該シャフトの遠位端に旋回可能に取り付けられた一対のジョーであって、各ジョーは、複数の後退可能なスタッドを有し、該ジョーは、該スタッドが該閉鎖装置の該ファスナを係合することによって、該閉鎖装置を着脱可能に保持するように適合されている、一対のジョーと、
該ハンドルを該一対のジョーに接合する連結アセンブリと
を備え、
該第1のトリガおよび該第2のトリガは、該ハンドルに向かって一緒に後退させられることにより、該ジョーを閉鎖し、かつ、該ファスナを展開し、
該第2のトリガは、該第1のトリガに対して後退させられることにより、該スタッドを該ファスナから係脱させ、
該第1のトリガおよび該第2のトリガは、一緒に該ハンドルから離れさせられることにより、該ジョーを開放する、
アプリケータ。
(項目2)
前記連結アセンブリは、前記シャフトに沿って配置された一対のスリーブを備え、該一対のスリーブは、前記トリガを前記ジョーおよびスタッドに接合する、項目1に記載のアプリケータ。
(項目3)
前記スリーブは、同軸である、項目2に記載のアプリケータ。
(項目4)
前記第1のトリガは、前記ジョーを閉鎖するために、第1のスリーブを移動させるように接続され、前記第2のトリガは、前記スタッドを係脱するために、第2のスリーブに接続されている、項目3に記載のアプリケータ。
(項目5)
前記第1のトリガは、前記ハンドル上に旋回可能に載置されている、項目4に記載のアプリケータ。
(項目6)
前記第2のトリガは、前記第1のトリガ上に旋回可能に載置されている、項目5に記載のアプリケータ。
(項目7)
前記第1のトリガと、前記第1のスリーブとの間に結合された第1のレバーと、前記第2のトリガと、前記第2のスリーブとの間に結合された第2のレバーとをさらに備えている、項目6に記載のアプリケータ。
(項目8)
前記第1のトリガと前記ハンドルとの間の相互係止具をさらに備え、該相互係止具は、該第1のトリガおよび前記第2のトリガが、一緒に後退させられる場合に係合され、該第2のトリガが、該第1のトリガに対して後退させられる場合に解放される、項目1に記載のアプリケータ。
(項目9)
前記ジョーは、前記シャフトの軸に対して、10°から20°の範囲内の角度で配置された平面内で、開放および閉鎖する、項目1に記載のアプリケータ。
(項目10)
前記連結アセンブリは、前記第2のトリガと前記スタッドとの間で接続されたワイヤを備え、該ワイヤは、前記ジョーと前記シャフトとの間の角度に従っている、項目9に記載のアプリケータ。
(項目11)
左心耳の上で圧縮体を閉鎖するための閉鎖装置であって、該装置は、
シャフトと、
該シャフトの遠位端に旋回可能に接続された一対のジョーと、
該シャフトの近位端に取り付けられたハンドルと、
該ハンドル上のトリガ機構であって、該左心耳の上で該ジョーを閉鎖し、該圧縮体を展開するために、該ジョーに結合されたトリガ機構と
を備え、
該ジョーは、該シャフトの軸に対して、10°から20°の範囲内の角度で配置された平面内で、開放および閉鎖する、装置。
(項目12)
閉鎖装置と、項目1から10のうちのいずれか1項に記載のアプリケータとを備えている、システム。
(項目13)
組織構造を閉鎖する方法であって、該方法は、
圧縮体を該組織構造上に位置付けることであって、少なくとも2つのコンプライアントな組織係合表面が、該構造の両側を係合する、ことと、
該ジョーを閉鎖し、該組織係合表面の間かつ該組織構造を通して複数のファスナを展開するために、該圧縮体を保持する一対のジョーに結合された第1のトリガを引っ張ることと、
該ジョーの複数のスタッドを、該ファスナとの接触から係脱するために、第2のトリガを引っ張ることと、
該ジョーを開放し、該圧縮体を解放するために、該第1のトリガを解放することと
を含む、方法。
(項目14)
左心耳の基部を閉鎖する方法であって、該方法は、
肋間切開を通して、該左心耳に向かいシャフトを挿入することと、
圧縮体を支持するジョーを該左心耳の上に位置付けることであって、該ジョーは、該シャフトの軸に対して、10°から20°の範囲内の角度で配置された平面内で、起動可能である、ことと、
該左心耳の上で該圧縮体を展開するために、該ジョーを閉鎖することと
を含む、方法。
Claims (5)
- 組織を分離するための組織分離システムであって、該組織分離システムは、
シャフトと、
該シャフトの遠位端に取り付けられるハンドルと、
該シャフトの遠位端に位置する第1のジョーおよび第2のジョーであって、該第1のジョーおよび該第2のジョーは、相互に対して移動するように適合されている、第1のジョーおよび第2のジョーと、
該ジョーのうちの少なくとも1つに対して移動可能な複数のスタッドと、
トリガ機構と
を備え、
該トリガ機構は、
該第1のジョーおよび該第2のジョーのうちの1つと作用可能に関連付けられた第1のトリガアセンブリであって、該第1のトリガアセンブリは、第1のトリガを備え、該第1のトリガは、該ハンドルに向かって第1の方向に移動して、該ジョーを相互に対して閉鎖し、組織を貫通するように構成されたファスナを備える圧縮体が該第1のジョーと該第2のジョーとの間に位置付けられたときに該組織の上で該圧縮体を展開する、第1のトリガアセンブリと、
該第1のトリガアセンブリと作用可能に関連付けられた第2のトリガアセンブリであって、該第2のトリガアセンブリは、第2のトリガを備え、該第2のトリガは、該第1のトリガが閉鎖されたときに該第1のトリガと係合し該第1のトリガを該ハンドルと相互係止する相互係止具に取り付けられた傾斜した表面と該第2のトリガ内の第2のピンを係合するように該第1の方向に該第1のトリガと一緒に移動するように第1のピンにより該第1のトリガ上に旋回可能に載置され、該第1の方向における該第2のトリガのさらなる移動が該傾斜した表面を下方に移動させて該相互係止具を該ハンドルから係脱することにより、該第1のトリガおよび該第2のトリガが該ハンドルから離れる第2の方向に移動可能であるようにし、かつ、該第1のジョーおよび該第2のジョーから該圧縮体を解放するようにする、第2のトリガアセンブリと
を備え、
該トリガ機構は、起動時、かつ、該圧縮体が該第1のジョーと該第2のジョーとの間に位置付けられたときに、以下の動作:(i)該第1のトリガが該第1の方向に移動したときの該スタッドに係合するような該ジョーの相互に対する閉鎖および該ファスナの展開、(ii)該第1のトリガに対して閉鎖するように該第2のトリガが該第1の方向に移動したときの該ファスナとの係合からの該スタッドの後退、(iii)該第1のトリガおよび該第2のトリガが該第2の方向に移動したときの該ジョーの相互に対する開放を順に生じさせるように構成されている、システム。 - 前記第1のジョーおよび前記第2のジョーは、第1の平面内で相互に対して開放および閉鎖し、該第1の平面は、前記シャフトの軸を通る第2の平面に対する角度オフセットで配置されている、請求項1に記載のシステム。
- 前記圧縮体は、2つの脚を有する、請求項1に記載のシステム。
- 前記第1のトリガが、前記ジョーを閉鎖し、かつ前記圧縮体を閉鎖するように前記第1の方向に十分に移動したときに、クリッカピンが移動して、該圧縮体が前記組織の上で閉鎖されたことを示す聴覚的なクリック音を発生させる、請求項1に記載のシステム。
- 前記相互係止具は、前記ハンドル内の複数のピンと該相互係止具のラチェット歯を係合することにより前記第1のトリガを該ハンドルと相互係止し、前記第1の方向における前記第2のトリガの前記さらなる移動が前記傾斜した表面を下方に移動させて該相互係止具の該ラチェット歯を該複数のピンから離して引っ張ることにより該相互係止具を該ハンドルから係脱する、請求項1に記載のシステム。
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JP2015116009A Active JP6166750B2 (ja) | 2009-08-11 | 2015-06-08 | 組織を分離するための組織分離システム |
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US20110190809A1 (en) | 2011-08-04 |
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CN102573665B (zh) | 2016-01-20 |
JP2015157166A (ja) | 2015-09-03 |
EP2464298B1 (en) | 2016-12-21 |
JP5807312B2 (ja) | 2015-11-10 |
US8647350B2 (en) | 2014-02-11 |
JP2013501588A (ja) | 2013-01-17 |
JP6166750B2 (ja) | 2017-07-19 |
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EP2464298A4 (en) | 2015-04-22 |
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