JP6415908B2 - 外科用器具において組織と機械的妨害とを区別する装置および方法 - Google Patents
外科用器具において組織と機械的妨害とを区別する装置および方法 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
- A61B17/068—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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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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
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- 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
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
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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
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
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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
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00137—Details of operation mode
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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
- 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
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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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
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
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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
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
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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
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00734—Aspects not otherwise provided for battery operated
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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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0803—Counting the number of times an instrument is used
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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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0804—Counting number of instruments used; Instrument detectors
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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
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0807—Indication means
- A61B2090/0811—Indication means for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
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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
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Description
本願は、米国仮特許出願第61/879,445号(2013年9月18日出願)に基づく優先権およびその利益を主張し、その全体の内容は、本明細書に参照によって援用される。
(1.技術分野)
本開示は、内視鏡外科手技を行うための外科用装置、デバイス、および/または、システム、ならびに、その使用方法に関連する。より具体的には、本開示は、組織をクランプ締めし、切断し、かつ/または、ステープル留めするための取り外し可能な使い捨てエンドエフェクタおよび/または単回使用エンドエフェクタとの併用のために構成された手持ち式電気機械外科用装置、デバイス、および/またはシステムに関連する。
数多くの外科用デバイス製造業者が、電気機械外科用デバイスを動作させ、かつ/または、操作するための専有の駆動システムを有する製品ラインを開発してきた。多くの例において、電気機械外科用デバイスは、再使用可能なハンドルアセンブリと、使い捨てまたは単回使用エンドエフェクタとを含む。エンドエフェクタは、使用の前にハンドルアセンブリに選択的に接続され、それから、処分するために、または、いくつかの例において、再使用のために殺菌するために、使用後、ハンドルアセンブリから接続解除される。
(項目1)
外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドルアセンブリ内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、該モータへの電流の供給を制御することと、該モータの電流引き込みを監視することとを行うように構成され、該コントローラは、該顎アセンブリ、該駆動アセンブリ、または、該モータのうちの少なくとも1つの機械的限界を示す、該電流引き込みの変化率に応答して、該モータへの該電流の供給を終了させるようにさらに構成されている、コントローラと
を備える、外科用器具。
(項目1A)
外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドル内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、該モータへの電流の供給を制御することと、該モータの電流引き込みを監視することとを行うように構成され、該コントローラは、該顎アセンブリ、該駆動アセンブリ、または、該モータのうちの少なくとも1つの機械的限界を示す、該電流引き込みの変化率に応答して、該モータへの該電流の供給を終了させるようにさらに構成されている、コントローラと
を備える、外科用器具。
(項目2)
前記コントローラは、前記電流引き込みの前記変化率が電流引き込み値の第1の範囲外にあるか否かを決定することによって、モータ電流が不安定であるときを決定するようにさらに構成されている、上記項目に記載の外科用器具。
(項目3)
前記コントローラは、前記電流引き込みの前記変化率が電流引き込み値の第2の範囲内にあるか否かを決定することによって、モータ電流が安定であるか否かを決定するようにさらに構成され、該第2の範囲は、前記第1の範囲内にある、上記項目のいずれかに記載の外科用器具。
(項目4)
前記コントローラは、前記第2の範囲内の電流引き込みサンプルの安定性カウンタを記憶するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目5)
前記コントローラは、前記安定性カウンタが所定の安定性閾値よりも大きいときにモータ電流が安定であることを決定する、上記項目のいずれかに記載の外科用器具。
(項目6)
前記コントローラは、前記モータ電流が安定であり、かつ、前記電流引き込みの前記変化率が第3の範囲内にあるか否かを決定することによって、前記モータが前記機械的限界に到達したときを決定するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目7)
前記第3の範囲は、前記第1の範囲内にあり、前記第2の範囲よりも高い、上記項目のいずれかに記載の外科用器具。
(項目8)
前記コントローラは、前記第3の範囲内の電流引き込みサンプルの事象カウンタを記憶するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目9)
前記コントローラは、前記事象カウンタが所定の事象閾値よりも大きいときに前記モータが前記機械的限界に到達したか否かを決定する、上記項目のいずれかに記載の外科用器具。
(項目10)
外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドルアセンブリ内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、機械的限界を示す、該モータによる電流引き込みの変化率に基づいて、該モータが該機械的限界に到達したか否かを決定するように構成されている、コントローラと
を備える、外科用器具。
(項目10A)
外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドル内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、機械的限界を示す、該モータによる電流引き込みの変化率に基づいて、該モータが該機械的限界に到達したか否かを決定するように構成されている、コントローラと
を備える、外科用器具。
(項目11)
前記コントローラは、前記電流引き込みの前記変化率が第1の範囲外にあるか否かを決定することによって、モータ電流が不安定であるか否かを決定するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目12)
前記コントローラは、前記電流引き込みの前記変化率の複数のサンプルが第2の範囲内にあるか否かを決定することによって、モータ電流が安定であるか否かを決定するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目13)
前記コントローラは、前記第2の範囲内の電流引き込みサンプルの安定性カウンタを記憶するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目14)
前記コントローラは、前記安定性カウンタが所定の安定性閾値よりも大きいときにモータ電流が安定であることを決定する、上記項目のいずれかに記載の外科用器具。
(項目15)
前記コントローラは、前記モータ電流が安定であり、かつ、前記電流引き込みの前記変化率の複数のサンプルが第3の範囲内にあるか否かを決定することによって、前記モータが前記機械的限界に到達したか否かを決定するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目16)
前記第2の範囲および前記第3の範囲は、前記第1の範囲内にあり、該第3の範囲は、該第2の範囲よりも高い、上記項目のいずれかに記載の外科用器具。
(項目17)
前記コントローラは、前記第3の範囲内の電流引き込みサンプルの事象カウンタを記憶するようにさらに構成されている、上記項目のいずれかに記載の外科用器具。
(項目18)
前記コントローラは、前記事象カウンタが所定の事象閾値よりも大きいときに前記モータが前記機械的限界に到達したことを決定する、上記項目のいずれかに記載の外科用器具。
外科用器具が提供される。外科用器具は、ハンドルアセンブリと、複数のステープルを含むステープルカートリッジおよび発射の際に複数のステープルを形成するアンビルを備える顎アセンブリと、ハンドル内に少なくとも部分的に位置し、顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、ハンドルアセンブリ内に配置され、駆動アセンブリに動作可能に結合されているモータと、モータに動作可能に結合されているコントローラであって、コントローラは、モータへの電流の供給を制御することと、モータの電流引き込みを監視することとを行うように構成され、コントローラは、顎アセンブリ、駆動アセンブリ、または、モータのうちの少なくとも1つの機械的限界を示す、電流引き込みの変化率に応答して、モータへの電流の供給を終了させるようにさらに構成されている、コントローラとを含む。
本開示の一実施形態に従って、外科用器具が、提供される。外科用器具は、ハンドルアセンブリと、複数のステープルを含むステープルカートリッジおよび発射の際に複数のステープルを形成するアンビルを備える顎アセンブリと、ハンドル内に少なくとも部分的に位置し、顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、ハンドルアセンブリ内に配置され、駆動アセンブリに動作可能に結合されているモータと、モータに動作可能に結合されているコントローラであって、コントローラは、モータへの電流の供給を制御することと、モータの電流引き込みを監視することとを行うように構成され、コントローラは、顎アセンブリ、駆動アセンブリ、または、モータのうちの少なくとも1つの機械的限界を示す、電流引き込みの変化率に応答して、モータへの電流の供給を終了させるようにさらに構成されている、コントローラとを含む。
上記の実施形態の一局面に従って、コントローラは、電流引き込みの変化率が電流引き込み値の第2の範囲内にあるか否かを決定することによって、モータ電流が安定であるか否かを決定するようにさらに構成され、第2の範囲は、第1の範囲内にある。
本開示の実施形態に従った外科用システムは、概して、10と指定され、複数の異なるエンドエフェクタを選択的に取り付けるように構成された手持ち式動力付電気機械器具の形態をなし、複数の異なるエンドエフェクタは、各々、手持ち式動力付電気機械外科用器具による作動および操作のために構成されている。
100 外科用器具
104 下部ハウジング部分
106 中間ハウジング部分
108 上部ハウジング部分
200 アダプタ
300 エンドエフェクタ
Claims (10)
- 外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドルアセンブリ内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、該モータへの電流の供給を制御することと、該モータの電流引き込みを監視することとを行うように構成され、該コントローラは、該顎アセンブリ、該駆動アセンブリ、または、該モータのうちの少なくとも1つの機械的限界を示す、該電流引き込みの変化率に応答して、該モータへの該電流の供給を終了させるようにさらに構成されている、コントローラと
を備え、
該コントローラは、該電流引き込みの該変化率が電流引き込み値の第1の範囲外にあるか否かを決定することによって、モータ電流が不安定であるときを決定するようにさらに構成されており、
該コントローラは、該電流引き込みの該変化率が電流引き込み値の第2の範囲内にあるか否かを決定することによって、モータ電流が安定であるか否かを決定するようにさらに構成されており、該第2の範囲は、該第1の範囲内にあり、
該コントローラは、該モータ電流が安定であり、かつ、該電流引き込みの該変化率が第3の範囲内にあるか否かを決定することによって、該モータが該機械的限界に到達したときを決定するようにさらに構成されており、
該第3の範囲は、該第1の範囲内にあり、該第2の範囲よりも高い、外科用器具。 - 前記コントローラは、前記第2の範囲内の電流引き込みサンプルの安定性カウンタを記憶するようにさらに構成されている、請求項1に記載の外科用器具。
- 前記コントローラは、前記安定性カウンタが所定の安定性閾値よりも大きいときにモータ電流が安定であることを決定する、請求項2に記載の外科用器具。
- 前記コントローラは、前記第3の範囲内の電流引き込みサンプルの事象カウンタを記憶するようにさらに構成されている、請求項1に記載の外科用器具。
- 前記コントローラは、前記事象カウンタが所定の事象閾値よりも大きいときに前記モータが前記機械的限界に到達したか否かを決定する、請求項4に記載の外科用器具。
- 外科用器具であって、該外科用器具は、
ハンドルアセンブリと、
複数のステープルを含むステープルカートリッジと、発射の際に該複数のステープルを形成するアンビルとを備える顎アセンブリと、
該ハンドルアセンブリ内に少なくとも部分的に位置し、該顎アセンブリおよびロックアウト機構に接続されている駆動アセンブリと、
該ハンドルアセンブリ内に配置され、該駆動アセンブリに動作可能に結合されているモータと、
該モータに動作可能に結合されているコントローラであって、該コントローラは、機械的限界を示す、該モータによる電流引き込みの変化率に基づいて、該モータが該機械的限界に到達したか否かを決定するように構成されている、コントローラと
を備え、
該コントローラは、該電流引き込みの該変化率が第1の範囲外にあるか否かを決定することによって、モータ電流が不安定であるか否かを決定するようにさらに構成されており、
該コントローラは、該電流引き込みの該変化率の複数のサンプルが第2の範囲内にあるか否かを決定することによって、モータ電流が安定であるか否かを決定するようにさらに構成されており、
該コントローラは、該モータ電流が安定であり、かつ、該電流引き込みの該変化率の複数のサンプルが第3の範囲内にあるか否かを決定することによって、該モータが該機械的限界に到達したか否かを決定するようにさらに構成されており、
該第2の範囲および該第3の範囲は、該第1の範囲内にあり、該第3の範囲は、該第2の範囲よりも高い、外科用器具。 - 前記コントローラは、前記第2の範囲内の電流引き込みサンプルの安定性カウンタを記憶するようにさらに構成されている、請求項6に記載の外科用器具。
- 前記コントローラは、前記安定性カウンタが所定の安定性閾値よりも大きいときにモータ電流が安定であることを決定する、請求項7に記載の外科用器具。
- 前記コントローラは、前記第3の範囲内の電流引き込みサンプルの事象カウンタを記憶するようにさらに構成されている、請求項6に記載の外科用器具。
- 前記コントローラは、前記事象カウンタが所定の事象閾値よりも大きいときに前記モータが前記機械的限界に到達したことを決定する、請求項9に記載の外科用器具。
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US14/463,134 | 2014-08-19 |
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US20190183502A1 (en) * | 2017-12-15 | 2019-06-20 | Ethicon Llc | Systems and methods of controlling a clamping member |
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CA2860712A1 (en) | 2015-03-18 |
AU2014218361B2 (en) | 2019-02-14 |
CN104434248A (zh) | 2015-03-25 |
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AU2014218366B2 (en) | 2018-08-02 |
CN104434248B (zh) | 2019-08-30 |
US10271840B2 (en) | 2019-04-30 |
US20150076206A1 (en) | 2015-03-19 |
EP3583904A1 (en) | 2019-12-25 |
US20150080912A1 (en) | 2015-03-19 |
EP2851009B1 (en) | 2019-09-04 |
JP2015058360A (ja) | 2015-03-30 |
AU2014218361A1 (en) | 2015-04-02 |
AU2014218366A1 (en) | 2015-04-02 |
US20190247044A1 (en) | 2019-08-15 |
EP3583904B1 (en) | 2024-01-03 |
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